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.
Department of Anaesthesiology, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria. bisolaobembe@yahoo.co.uk
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Onajin-Obembe
D000556:Ambulatory Surgical Procedures; D000758:Anesthesia / Q000639:trends*; D005260:Female; D005831:Genital Diseases, Female / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D016896:Treatment Outcome