Portal de Periódicos da CAPES

Anesthetic techniques for laparoscopic tubal ligation.

1981; Lippincott Williams & Wilkins; Volume: 55; Linguagem: Inglês

1528-1175

Soni Soni, Richard E. Burney,

Nausea and vomiting management

A study was conducted to compare the effects of various anesthetic techniques on postoperative morbidity and recovery times in laparoscopic tubal ligation patients. 30 healthy patients mean age 33.10 years and scheduled for laparoscopic tubal ligation were randomly assigned to 1 of 4 anesthetic techniques: group 1 general anesthesia -- N20 70% in 02 fentanyl 2 mcg/k plus 1 mcg/kg after 20 minutes as needed and succinylcholine drip; group 2 -- general anesthesia fentanyl 1 mcg/kg followed by N20 70% in 02 with enflurane 1-2% inspired; group 3 -- general anesthesia meperidine 1-1.5 mg/kg plus 0.5 mg/kg after 30 minutes as needed N20 70% in 02 and succinylcholine drip; and group 4 -- continuous epidural anesthesia with 2% xylocaine with epinephrine 1:200000. All patients were given diazepam 5 mg intravenously prior to anesthesia. All general anesthesia patients were induced with curare 3 mg thiopental 4-5 mg/kig and succinylcholine 100 mg. All general anesthesia patients were intubated. Observations following surgery were recorded at 15 minute intervals. Patients were moved to a waiting area where they were given fluids and ambulated prior to discharge. 24 hours after surgery each patient was called and asked about pain nausea vomiting sore throat or any other complaints. Almost all patients were awake within 15 minutes. There were no changes in vital signs which required therapy in any patient. The times to first postoperative fluids followed a pattern similar to that for pain medication but the times to ambulation showed less variation between groups. Contrary to expectations use of a longer acting narcotic (meperidine) did not delay recovery from anesthesia or time of discharge. The 2 techniques which provided the best postoperative pain relief (meperidine and epidural) also produced the least nausea the shortest times to ambulation and more rapid tolerance of postoperative fluids. Laparoscopic tubal ligation is not without pain in the postoperative period. Those anesthetic techniques which provide the best pain relief in the first 2 hours have the lowest overall morbidity and most rapid recovery.