Comparison of Spinal and General Anesthesia in Gynecologic Diagnostic Laparoscopy

Nahid Zirak, Farideh Golhasani Keshtan, Majid Razavi*, Leli Hafizi, Nasrin Ahangarian, Nayereh Khadem, Mahsa Rajaei


Background and Aim: Laparoscopic surgery is usually performed under general anesthesia (GA), but in patients with any contraindication for GA, spinal anesthesia (SA) is administered. In this study, we aimed to evaluate and report SA as a safe technique for laparoscopic surgeries.

Materials and Methods: In this prospective study, 30 patients who were candidates for diagnostic laparoscopic surgery were divided into 2 groups: one group was administered GA and the other group was administered SA. In both the groups, oxygen saturation (SpO2), mean arterial pressure (MAP), respiratory rate (RR), heart rate (HR), and end-tidal carbon dioxide (ETCO2) were recorded pre- and intra-operatively. Nausea and vomiting as well as shoulder pain were evaluated during recovery, at 2, 8, and 24 hours after laparoscopy.

Results: In this study, the vital signs were evaluated before and during inflation, after deflation, and during recovery in both the groups. There were no significant differences in SpO2 and HR (P = .141 and P = .531, respectively), but ETCO2 after inflation (P = .015) and RR and ETCO2 during inflation (P = .004 and P = .013, respectively) were significantly different between the 2 groups. MAP in all the stages, except in the preinflation phase, was significantly different between the 2 groups; indeed, RR and ETCO2 slightly increased in the SA group. Moreover, there was a greater reduction of MAP during inflation in the SA group compared with the GA group. The incidence of shoulder pain was significantly different between the 2 groups at 2, 8, and 24 hours after the laparoscopy (P = .009, P = .035, and P = .011, respectively). During recovery, the incidence of nausea was significantly higher in the SA group (P = .024).

Conclusion: Administering SA for diagnostic laparoscopy in women is safe, having its own benefits and adverse effects just like any other anesthesia technique.

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