The feasibility of laparoscopic general surgery under regional anaesthesia

ABSTRACT

In general, laparoscopic procedures of the abdominal cavity necessitate endotracheal intubation and mechanical ventilation due to the induction of pneumoperitoneum. The increased intra-abdominal pressure together with the increased carbon dioxide load to the lungs are considered as better managed under mechanical ventilation, making thus general anesthesia a necessary requirement for these operations. In the past decade, a small number of reports appeared involving regional anaesthesia for laparoscopic general surgery, including patients with coexisting pulmonary disease who were deemed high risk for general anaesthesia. More recently, a limited number of studies showed the feasibility of the application of regional anaesthesia on healthy subjects. Nowadays, the properly controlled randomized studies addressing this issue remain limited, but their results show that the strong indication of general anaesthesia for laparoscopic general needs to be re-evaluated.