Evaluation of laparoscopic surgery under low-pressure pneumoperitoneum and regional anesthesia

Objectives: assessment of the feasibility and safety of laparoscopic procedures under low-pressure CO2 pneumoperitoneum and regional anaesthesia. Patients and methods: 30 adult ASA I or II patients admitted for different laparoscopic procedures were enrolled in the study. Pre-anaesthetic values of HR, RR, body temperature, BP and pulse oximetry were recorded. Spinal an aesthesia was given in sitting position with a 25 G needle into the L1 - L2 subarachnoid space. Different laparoscopic procedures were performed with the pneumoperitoneum was maintained with low CO2 pressure at 8-12 mm Hg. Anaesthesia time, Surgery time, Intraoperative complications and Conversion from regional to general anesthesia or from laparoscopic to open technique were recorded and the technical difficulty was ranked by the surgeon. Results: 28 of the patients (93.3%) completed the procedure under spinal anaesthesia and 2 (7.7%) were converted to general anaesthesia. Rank of technical difficulty ranged from 2/5 in 24 cases (80%) to 4/5 in one case (3.3%). Overall operative and anaesthesia times ranged from 30 to 65 minutes (Mean 37.33 + 10.15 min.) and 45 to 90 minutes (Mean 53+ 12.12 min.) respectively. No intraoperative complications and none of the patients was converted to open surgery. The vitals were maintained at a normal range. Mean arterial pressure ranged from 86.6 to 101.67 (Mean 93.6+5). The maximum respiratory rate during pneumoperitoneum ranged from 16 to 26 per minute (Mean 19 + 3.8). Conclusion: Laparoscopic procedures under regional anesthesia with low-pressure pneumoperitoneum seems to be safe and feasible.