Total Laparoscopic Hysterectomy Under General Anesthesia with or without Epidural Block- a Randomized Control Study

Dr. Namrata Gupta; Dr. Prafulla Patil; Dr. Savita Babbar

Volume : IX, Issue : IV, April - 2020

Total Laparoscopic Hysterectomy Under General Anesthesia with or without Epidural Block- a Randomized Control Study

Dr. Namrata Gupta, Dr. Prafulla Patil, Dr. Savita Babbar

Abstract :

Background: The choice of safe and comfortable anaesthetic technique for gynaecological laparoscopic surgery is mostly limited to general anaesthesia because of patient discomfort and shoulder pain associated with creation of pneumoperitoneum. Epidural anaesthesia along with general anaesthesia can have added advantage to provide stable haemodynamics in such situations. The present study was conducted to evaluate the efficacy of general anaesthesia alone or in combination with epidural block for maintaining stable haemodynamics and better operative field in total laparoscopic hysterectomy (TLH). Material and Methods: It was a prospective randomized controlled study performed on 60 patients of ASA grade I/II patients of age 29–60 years, scheduled for total laparoscopic hysterectomy under general anaesthesia. Patients were randomized in two equal group of 30 each: Group G received plain general anaesthesia and Group GE received combined GA with Epidural anaesthesia. Hemodynamic parameters were compared at various stages (at preinduction, post induction, insufflation, desufflation and extubation). Surgeons satisfaction about operating conditions in form of poor, good and excellent were also noted. Results: Haemodynamic parameters were successfully attenuated in GE group. There was significant rise in heart rate, systolic blood pressure, and diastolic blood pressure in group G. Operating conditions, subjectively assessed by surgeons, were excellent in GE group compare to group G. Conclusion: In conclusion, GA with epidural anaesthesia is a safe option for TLH with stable haemodynamics and better operating condition. More studies keeping the operative surgeon consistent for subjective assessment is definitely required in the future.