8843 Laparoscopic Hysterectomy Under Minimally Invasive Anesthesia.

Abstract

<h3>Study Objective</h3> In the minimally invasive era, laparoscopic gynecological surgery is currently performed under general anesthesia (GA), although regional anesthesia (RA) could be considered a valid alternative in some specific settings. Aim of this study was to assess the feasibility and the perioperative outcomes of laparoscopic hysterectomy in regional anesthesia from the point of view of the surgeon, anesthesiologist and patient. <h3>Design</h3> Retrospective case series. <h3>Setting</h3> University of Naples Federico II. <h3>Patients or Participants</h3> Five patients affected by benign gynecological disease (atypical endometrial hyperplasia or uterine leiomyomas). <h3>Interventions</h3> Laparoscopic hysterectomy under RA. <h3>Measurements and Main Results</h3> A database search was performed to identify patients who underwent laparoscopic hysterectomy under RA from April 2020 and September 2021. The postoperative pain, nausea and vomiting (PONV) and the antiemetic/analgesic intake were evaluated. Postoperative surgical and anesthesiological variables were recorded. Duration of surgery was 84 ± 4.18 and no conversion to GA was required. According to VAS score, the postoperative pain during the whole observation time was less than 4 (median). A faster resumption of bowel motility (≤ 9hours) and patient's mobilization (≤ 4hours) were observed as well as a low incidence of post-operative nausea and vomit. Early discharge and greater patient's satisfaction were recorded. Intraoperatively pain score on a Likert scale during all the stages of laparoscopy in RA was assessed with only 2 patients complaining scarce pain (= 2) at pneumoperitoneum. <h3>Conclusion</h3> RA showed to have a great impact on surgical stress and to guarantee a quicker recovery without compromising surgical results. RA technique could be a viable option for patients undergoing laparoscopic hysterectomy.