Postoperative Complications after Ambulatory Gynecologic Laparoscopy: Comparison between Three Different Techniques

Recently laparoscopy has become a common out patient – base surgical procedure. An ideal anesthetic technique should provide a rapid and smooth induction, rapid recovery and minimal postoperative complications. In spite of no single ideal technique has been shown for outpatient laparoscopy, it seems that total intravenous anesthesia with propofol has more rapid induction and recovery profiles and less side effects, in comparison with inhalational agents. In This study we compared the total intravenous anesthesia with inhalational agents during diagnostic gynecological laparoscopy. We also evaluated the effect of N2o addition on intravenous propofol anesthesia. Methods and Materials: In this Prospective study 150 women (age: 25-45) who were in physical class I and II of American Association of Anesthesiologists and were candidate for diagnostic laparoscopy were elected. They randomly subdivided in three groups. Group one received anesthesia with thiopental, halothane and oxygen, group two received Total Intravenous anesthesia with propofol and oxygen. Group three received propofol anesthesia with 50% N2O - oxygen. The incidence and severity of post operative nausea and vomiting, degree of sedation, severity of pain and also stay in recovery unit were evaluated. The incidence of Postoperative nausea and vomiting, sedation and time of discharge from recovery were significantly lower in group 2 and 3 compared with group 1 (P<0.05). Addition of N2O did not increase the incidence of Postoperative nausea and vomiting, but moderately increased the severity. There were not any significant difference between different groups in term of severity of pain and need for analgesia (P>0.05). Total intravenous anesthesia with propofol in comparison with inhalation anesthesia is a better choice for outpatient gynecologic laparoscopy. The results of this study showed that addition of N2O to propofol does not improve postoperative analgesia. Also, it did not increase the postoperative complications and recovery time.