Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy.
Department of Anesthesiology and Intensive Care Medicine, Policlinico - Federico II University Hospital, Naples, Italy.
Arch Gynecol Obstet. 2022 Dec;306(6):2001-2007. doi: 10.1007/s00404-022-06727-6. Epub 2022 Aug 5.
Regional anesthesia (RA) is considered as a "minimally invasive technique" to achieve anesthesia. 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.
A retrospective search was performed to identify patients who underwent laparoscopic hysterectomy under RA from April 2020 to September 2021. Five patients affected by benign gynecological disease (atypical endometrial hyperplasia or uterine leiomyomas) were included.
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 (≤ 9 h) and patient's mobilization (≤ 4 h) 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 was assessed on Likert scale during all the stages of laparoscopy in RA, with only 2 patients complaining scarce pain (= 2) at pneumoperitoneum.
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.
区域麻醉（RA）被认为是一种实现麻醉的“微创技术”。为了从外科医生、麻醉师和患者的角度评估 RA 下腹腔镜子宫切除术的可行性和围手术期结果。
回顾性搜索 2020 年 4 月至 2021 年 9 月期间接受 RA 下腹腔镜子宫切除术的患者。纳入 5 例良性妇科疾病患者（非典型子宫内膜增生或子宫肌瘤）。
评估了术后疼痛、恶心、呕吐（PONV）和止吐/镇痛药物的摄入情况。记录了术后手术和麻醉学变量。手术时间为 84±4.18 分钟，无需转为全身麻醉。根据 VAS 评分，整个观察期间的术后疼痛均小于 4（中位数）。观察到更快的肠蠕动恢复（≤9 小时）和患者活动（≤4 小时）以及较低的术后恶心和呕吐发生率。记录了早期出院和更高的患者满意度。在 RA 下的腹腔镜手术的所有阶段，术中疼痛评分均采用李克特量表进行评估，只有 2 名患者在气腹时抱怨轻微疼痛（=2）。
RA 对手术应激有很大影响，并能保证更快的恢复，而不会影响手术结果。RA 技术可能是接受腹腔镜子宫切除术患者的可行选择。
