Laparoscopic gynecological surgery under minimally invasive anesthesia: a prospective cohort study

Abstract Objective: To assess the feasibility and the perioperative outcomes of laparoscopic gynecological surgery in regional anesthesia (RA) from the point of view of the surgeon, anesthesiologist and patient. Design: Prospective cohort study Setting: University Hospital Federico II of Naples Population: Women planned to undergo gynecologic laparoscopy surgery for benign pathology. Methods: Women were assigned, according to their preference, to either RA (Group A) or general anesthesia (GA)(Group B). Surgical, anesthesiological and postoperative recovery data were recorded. Statistically significant differences between the two groups regarding social, demographic, medical and psychiatric data. Statistically significant differences between the two groups regarding social, demographic, medical and psychiatric data. Main outcome mesure: The primary outcome measure was postoperative pain. Secondary outcomes included mobilization, length of hospital stay, global surgeons and patient satisfaction, intraoperative pain assessment in Group A. Results: Immediate postoperative pain was significantly lower in Group A 0 vs 2 (p<0.001), also at 6 h 1.5 vs 3 (p =0.004), with no significant differences at 24 h. The secondary outcome demonstrated early patient’s mobilization (p<0.001) as well as early discharge (p<0.001) and greater patient’s satisfaction for the Group A. A maximum pain score of 3 points out of 5 was recored through the entire surgery. Conclusion: RA showed to decrease the impact of surgical stress and to guarantee a quicker recovery without compromising surgical results. As well as different surgical approaches can be selected to treat different pathologies, RA technique could be a viable option for patients. Keywords: gynecological surgery; regional analgesia; postoperative pain.