ANESTHESIA FOR LAPAROSCOPIC GENERAL-SURGERY

Laparoscopic surgery minimises postoperative morbidity. Patient benefi ts include reduction in postoperative pain, better cosmetic result and quicker return to normal activities. Hospital stay is shortened resul ting in a reduction in overall medical cost. The intraoperative requir ements of laparoscopic surgery however can lead to serious physiologic al changes and complications. While them is a low but definite periope rative mortality rate associated with minor gynaecologic laparoscopic procedures, laparoscopic general surgical procedures are performed on older patients and patients with acute surgical conditions and are lik ely to be associated with a higher incidence of perioperative complica tions. The major problems during laparoscopic surgery are related to t he cardiopulmonary effects of pneumoperitoneum, systemic carbon dioxid e absorption, extraperitoneal gas insufflation, venous gas embolism an d unintentional injuries to intra-abdominal structures. An appraisal o f the potential problems is essential for optimal anaesthetic care of patients undergoing laparoscopic surgery. Appropriate anaesthetic tech niques and monitoring facilitate surgery and allow early detection and reduction of complications. The need for rapid recovery and short hos pital stay impose additional demands on the anaesthetist for skillful practice.