EFFECTIVENESS AND SAFETY OF COMBINED EPIDURAL AND GENERAL-ANESTHESIA FOR LAPAROSCOPIC CHOLECYSTECTOMY

Background and Objectives. The aim of this study was to compare the ef ficacy and safety of two anesthesia techniques, combined epidural/gene ral anesthesia (CEGA) versus total intravenous anesthesia (TIVA), for laparoscopic cholecystectomy. Methods. Forty patients were randomly as signed to one of two different groups: group A received TIVA and group B received CEGA. At preset times during the operation, systolic and d iastolic arterial pressure, heart rate, oxygen saturation (SaO(2)) and end-tidal carbon dioxide (Etco(2)) were monitored. Postoperatively, r ecovery (Steward's test) and analgesia (visual analog scale [VAS] pain scores) were assessed, as well as the incidence of adverse effects. R esults. The groups were comparable as to demographic data and duration of surgery and of anesthesia. Intraoperative parameters also showed n o statistical differences. Both groups had a rapid recovery (Steward s core of 6 within 12 minutes), but group B showed better recovery score s at 4 minutes. Postoperative pain was well controlled in both groups, but group B exhibited better scores at postoperative hour 2. The inci dence of postoperative side effects was low in both groups. Conclusion s. The use of CEGA for laparoscopic cholecystectomy seems to be effect ive and safe and to offer some advantages as compared to TIVA alone. C EGA can control pain due to CO2-induced peritoneal irritation, providi ng excellent intra- and postoperative analgesia. CEGA does not require the use of intraoperative intravenous opioids and shortens recovery t ime, without increasing the incidence of side effects.