GENERAL ANESTHESIA VERSUS COMBINED SPINAL-EPIDURAL ANESTHESIA IN GYNECOLOGIC LAPAROSCOPIC SURGERIES: A COMPARATIVE STUDY

Abstract

Background: The choice of anesthesia in laparoscopic gynecological surgeries plays a critical role in patient outcomes, including intraoperative stability, postoperative recovery, pain control, and overall satisfaction. General anesthesia (GA) and combined spinal-epidural anesthesia (CSEA) are two commonly employed techniques, each with distinct advantages and limitations. However, limited evidence exists regarding their comparative efficacy and safety in gynecological laparoscopic procedures.

Objective: To compare the effectiveness of GA and CSEA in laparoscopic gynecological surgeries with respect to hemodynamic stability, postoperative pain, recovery time, and perioperative complications.

Methods: This randomized controlled trial included 120 patients undergoing gynecological laparoscopic surgery. Participants were randomly assigned to two equal groups: GA (n=60) and CSEA (n=60). Parameters assessed included intraoperative hemodynamic stability (heart rate, blood pressure), postoperative pain (measured by visual analog scale), recovery time (time to ambulation and discharge), and complications (nausea, vomiting, respiratory depression).

Results: Patients in the CSEA group demonstrated superior hemodynamic stability, lower postoperative pain scores, and faster recovery times compared to those in the GA group. Complications such as nausea, vomiting, and respiratory depression were less frequent in the CSEA group.

Conclusion: CSEA appears to be a safe and effective alternative to GA in laparoscopic gynecological surgeries, particularly for patients with comorbidities or at higher risk of hemodynamic instability. Further studies with larger sample sizes are warranted to confirm these findings and explore long-term outcomes.