Comparative study of spinal anesthesia vs monitored anesthetic control in hysteroscopies

Abstract

The increase in the use of surgical hysteroscopy for the diagnosis and/or treatment of gynecological pathologies leads the anesthesiologist to decide which anesthetic technique presents the best parameters for patient satisfaction, either spinal anesthesia at low doses of local anesthetic plus opioid or the CAM (monitored anesthetic control). Aim: To compare the results in analgesia, adverse reactions and recovery from spinal anesthesia vs monitored anesthetic control in surgical hysteroscopies.

A retrospective and comparative observational clinical study in therapeutic hysteroscopies from December 2021 to February 2022 was carried out. The expected number of patients was 30 per group aged 18 to 70 years ASA I or II: Group A: Patients who received spinal anesthesia; Group B: Patients under CAM. The Kruskal Wallis or Student's T test was applied in the comparison of means (after application of the Shapiro Wilks normality test) and the chi-square test in the correlation of categorical variables. In all cases, a significance level of less than 0.05 was used.

Patients with spinal anesthesia at low doses of local anesthetic plus opioids presented good analgesic quality with few adverse reactions and hemodynamic changes without differences with group B but with a prolonged recovery time in the immediate postoperative period significantly compared to CAM, increasing the stay in care post operative. Likewise, group B required a significantly higher number of morphine rescues in the postoperative period but maintaining similar analgesia between both groups.

The analysis of the results of this study show that both anesthetic techniques are equally effective for ambulatory hysteroscopies in the operating room, with the spinal anesthesia group presenting a longer recovery.