title: Mode of anesthesia and postoperative symptoms following abdominal hysterectomy in a fast-track setting.
abstract: OBJECTIVE
  To determine whether postoperative symptoms differ between women who undergo abdominal benign hysterectomy in a fast-track model under general anesthesia or spinal anesthesia with intrathecal morphine.
  
  
  METHODS
  Secondary analysis from a randomized, open, multicenter study.
  
  
  METHODS
  Five hospitals in south-east Sweden.
  
  
  METHODS
  One-hundred and eighty women scheduled for benign hysterectomy were randomized; 162 completed the study; 82 were allocated to spinal and 80 to general anesthesia.
  
  
  METHODS
  The Swedish Postoperative Symptoms Questionnaire, completed daily for 1 week and thereafter once a week until 5 weeks postoperatively.
  
  
  METHODS
  Occurrence, intensity and duration of postoperative symptoms.
  
  
  RESULTS
  Women who had hysterectomy under spinal anesthesia with intrathecal morphine experienced significantly less discomfort postoperatively compared with those who had the operation under general anesthesia. Spinal anesthesia reduced the need for opioids postoperatively. The most common symptoms were pain, nausea and vomiting, itching, drowsiness and fatigue. Abdominal pain, drowsiness and fatigue occurred significantly less often and with lower intensity among the spinal anesthesia group. Although postoperative nausea and vomiting was reported equally in the two groups, vomiting episodes were reported significantly more often during the first day after surgery in the spinal anesthesia group. Spinal anesthesia was associated with a higher prevalence of postoperative itching.
  
  
  CONCLUSIONS
  Spinal anesthesia with intrathecal morphine carries advantages regarding postoperative symptoms and recovery following fast-track abdominal hysterectomy.
authors.affiliation: Division of Women and Child Health, Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden. ninnie.borendal.wodlin@lio.se
authors.forename: Ninnie Borendal
authors.initials: NB
authors.lastname: Wodlin
authors.forename: Lena
authors.initials: L
authors.lastname: Nilsson
authors.forename: Kristofer
authors.initials: K
authors.lastname: Arestedt
authors.forename: Preben
authors.initials: P
authors.lastname: Kjølhede
mesh_terms: D000768:Anesthesia, General / Q000009:adverse effects / Q000379:methods*; D000775:Anesthesia, Spinal / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005831:Genital Diseases, Female / Q000601:surgery*; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D010149:Postoperative Pain / Q000209:etiology; D020250:Postoperative Nausea and Vomiting / Q000209:etiology; D011446:Prospective Studies; D011788:Quality of Life; D018709:Statistics, Nonparametric; D014839:Vomiting / Q000209:etiology