Patients undergoing laparoscopic gynecological surgery will receive regional anesthesia or general anesthesia with endotracheal intubation. The investigators aim to evaluate the feasibility and safety of regional anesthesia for laparoscopic gynecological procedures.
Commonly, laparoscopic gynecological procedures are performed under general anesthesia with endotracheal intubation. The use of regional anesthesia in laparoscopy is reserved to patients declared unfit for general anesthesia because of severe comorbidities or it is applied in combination with general anesthesia to decrease postoperative pain. Recently, growing literature evidence supports the use of regional anesthesia in patients undergoing laparoscopy. The combination of minimally invasive surgery with regional anesthesia could increase the advantages of laparoscopic operations (less postoperative pain, shorter hospital stay, etc).
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
28
Used for general anesthesia for gynecological laparoscopic procedures, together with Propofol, Sufentanil, Rocuronium, Sevoflurane
Used for regional anesthesia (spinal or combined spinal-epidural anesthesia) for gynecological laparoscopic procedures together with Bupivacaine; and for general anesthesia for gynecological laparoscopic procedures, together with following drugs: Midazolam, Propofol, Rocuronium, Sevoflurane
Used for general anesthesia for gynecological laparoscopic procedures, together with the following drugs: Midazolam, Sufentanil, Rocuronium, Sevoflurane
Cardiothoracic and Vascular Anesthesia and Intensive Care, S. OrsolaMalpighi University Hospital
Bologna, BO, Italy
Gynecology and Physiopathology of Human Reproductive Unit, University of Bologna, S. Orsola-Malpighi Hospital
Bologna, BO, Italy
Feasibility and safety: Clavien-Dindo Classification (from Grade I to V)
Evaluation of feasibility and safety of regional anesthesia for gynecological laparoscopic surgery, considering complications using Clavien-Dindo Classification (from Grade I to V)
Time frame: From the surgery time, assessed up to 7 days after surgery
Postoperative nausea or emesis.
evaluation of the presence of postoperative nausea or emesis.
Time frame: 48 hours after surgery
Days of hospitalization
Number of days of hospitalization after surgery.
Time frame: From surgery to hospitalization discharge, assessed up to 7 days after surgery.
Day of mobilization.
Day of first mobilization after surgery.
Time frame: From surgery to day of first mobilization, assessed up to 7 days after surgery.
Day of feeding.
Day of first feeding after surgery.
Time frame: From surgery to day of first feeding, assessed up to 7 days after surgery.
Day of canalization.
Day of first canalization after surgery.
Time frame: From surgery to day of first canalization, assessed up to 7 days after surgery.
Intraoperative pain: verbal numeric rating scale
Intraoperative pain in patients submitted to regional anesthesia (Group B), using a verbal numeric rating scale, from 0 to 10, where 0 is no pain and 10 is the worse pain ever
Time frame: Intraoperative: from skin incision to cutaneous suture.
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Used for general anesthesia for gynecological laparoscopic procedures, together with the following drugs: Midazolam, Propofol, Sufentanil, Sevoflurane
Used for general anesthesia for gynecological laparoscopic procedures, together with the following drugs: Midazolam, Propofol, Sufentanil, Rocuronium
Used for regional anesthesia (spinal or combined spinal-epidural anesthesia) for gynecological laparoscopic procedures, together with Sufentanil
Minimum respiratory rate
Minimum respiratory rate during surgery.
Time frame: Intraoperative: from skin incision to cutaneous suture.
End-Tidal PCO2 before pneumoperitoneum.
End-Tidal PCO2 is measured by capnography.
Time frame: Intraoperative: from anesthesia to the beginning of pneumoperitoneum induction.
End-Tidal PCO2 during pneumoperitoneum.
End-Tidal PCO2 is measured by capnography.
Time frame: Intraoperative: pneumoperitoneum time expressed in minutes.
Postoperative pain: numerical rating scale
Evaluation of postoperative pain in patients undergoing general or regional anesthesia for gynecological laparoscopic surgery, measured with verbal numerical rating scale, from 0 to 10, where 0 is no pain and 10 is the worse pain ever
Time frame: 48 hours after surgery