Comparative Evaluation of Spinal Anesthesia and General Anesthesia in Gynecologic Diagnostic Laparoscopy

Document Type : Original Article

Authors

1 Associate professor, Department of Anesthesia, Lung Disease Research Center, Faculty of Medicine, Mashhad University of Medicine Sciences, Mashhad, Iran.

2 Assistant professor, Department of Anesthesia, Lung Disease Research Center, Faculty of Medicine Mashhad University of Medicine Sciences, Mashhad, Iran.

3 Associate professor, Department of Obstetrics and Gynecology, Women's Health Research Center, Faculty of Medicine, Mashhad University of Medicine Sciences, Mashhad, Iran.

4 M.Sc. of Physiology, Faculty of Medicine, Mashhad University of Medicine Sciences, Mashhad, Iran.

5 Resident, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medicine Sciences, Mashhad, Iran.

6 Professor, Department of Obstetrics and Gynecology, Women's Health Research Center, Faculty of Medicine, Mashhad University of Medicine Sciences, Mashhad, Iran.

Abstract

Introduction: The preferred method in anesthesia of the patients who are candidate for gynecology diagnostic laparoscopic surgeries is general anesthesia (GA) usually, but in patients with any contraindication for GA, Spinal Anesthesia (SA) is used. This study was performed with aim to compare GA with SA technique for gynecology diagnostic laparoscopic surgeries.
Methods:  This clinical randomized and prospective study was performed on 30 patients who were candidate for gynecology diagnostic laparoscopic surgeries in 2012-2013. The subjects were divided in two groups of GA & SA (n=15 in each group). Data collection tools were checklist and observation. SPO2، MAP، RR، HR، ETCO2 were recorded preoperative and intraoperative. Nausea, vomiting and shoulder pain were evaluated in recovery, 2, 8 and 24 hours after surgery. Data were analyzed by SPSS software (version 15), and using T-test and Chi-square. P <0.05 was considered significant.
Results: The changes of SPO2 and HR at the studied times were not significantly difference between two groups (p=0.141, p=0.531, respectively), and only EtCO2 after Inflation (p=0.015) and RR and EtCO2 during inflation (p=0.004, p=0.013, respectively) were significantly different between two groups. MAP in all the state in the SA group was lower except before inflation. The incidence of shoulder pain at 2,8 and 24 hours after surgery had significant difference between two groups (p=0.009, p=0.035 and p=0.011, respectively); so that it was higher in the SA group. Nausea in the recovery had higher incidence in SA group (p=0.024).
Conclusion: The use of SA for diagnostic laparoscopic surgeries in women is safe and reliable and like as any other anesthesia method has benefits and disadvantages.

Keywords

References

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The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 20, Issue 7
September 2017
Pages 1-7

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