Daycase laparoscopic gynaecological procedures--current trends in anaesthetic management.
Laparoscopy for gynaecological procedures is minimally invasive and is mostly performed as a daycase. The advancement of laparoscopy and minimal access surgery has greatly influenced the evolution of anaesthetic techniques. Preoperative assessment can be simplified by the use of questionnaires in pre-assessment clinics. Intraoperative intravenous fluid administration improves patient well being while airway management can be by the age-old, tried and trusted orotracheal tube or by the newer laryngeal mask airways. The use of propofol as an induction agent, a short acting non-depolarizing muscle relaxant e.g. mivacurium, an inhalational anaesthetic agent with a fast wake up time e.g. sevoflurane or desflurane, and short acting opioids e.g. fentanyl guarantees quick recovery of patients. The trend towards a multimodal approach to postoperative pain and prevention of postoperative nausea and vomiting (PONV) improves postoperative profile of day case gynaecological patients. Expertise in providing a pneumoperitoneum with carbon dioxide is desirable even as other options for lifting the abdominal wall are being investigated.
Onajin-Obembe
B O I
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Department of Anaesthesiology, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria. bisolaobembe@yahoo.co.uk
D000556:Ambulatory Surgical Procedures; D000758:Anesthesia / Q000639:trends*; D005260:Female; D005831:Genital Diseases, Female / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D016896:Treatment Outcome