“Comparison of General and Regional Anesthesia in Laparoscopic Gynecological Surgeries: Recovery and Pain Outcomes”

Abstract

Introduction: Laparoscopic surgery has become the gold standard for the surgical care of several benign gynecological illnesses, such as endometriosis, leiomyoma, adhesions, and infertility, because of its "minimally invasive" nature, which reduces surgical damage, discomfort, and hospitalization time. In this study, we aimed to compare general anesthesia with regional anesthesia in laparoscopic gynecological surgeries in terms of pain outcomes and recovery.

Methods: This cross-sectional study was conducted in the Department of Anaesthesia, Analgesia and Intensive Care Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, from July 2023 to June 2024. This study included 100  patients who underwent laparoscopic gynecological surgeries and were then divided into two groups: Group A- Patients who received regional anesthesia, such as SAB (Subarachnoid block), and Group B- Patients who received general anesthesia.

Result: The baseline characteristics were comparable between the groups, with no significant differences in mean age, BMI, parity, ASA status, or indications for surgery. Postoperatively, the GA group had significantly higher MAP (99.37 ± 8.62 mmHg vs. 90.04 ± 8.36 mmHg, p = 0.041) and longer hospital stays (5.0 ± 1.1 days vs. 4.5 ± 0.6 days, p = 0.001). Pain scores at 8 hours postoperatively were significantly lower in the RA Group (2.17 ± 1.97 vs. 3.93 ± 1.53, p = 0.002). The RA group reported fewer complications, with a higher proportion of patients experiencing no complications (62% vs. 56%).

Conclusion: This study showed that regional anesthesia demonstrated better postoperative outcomes, including shorter hospital stays, lower pain scores at 8 hours, and fewer complications, compared to general anesthesia. These findings suggest that RA may be a preferable option for laparoscopic gynecological surgical procedures.