Spinal and epidural anesthesia for laparoscopic abdominal surgery: 84 procedures

From its origins, abdominal surgery has benefited from the advantages of general anesthesia. At the end of 20th century, regional anesthesia, as well as minimally invasive surgery, made a significant appearance. Thoracic neuraxial anesthesia has been used in major abdominal surgery and in oncology, on patients who, due to cardiorespiratory problems, could not undergo GA. Given the good results obtained, the method was also applied to patients in good conditions. CESA (combined epidural and spinal anesthesia) is emerging for minimally invasive surgery. Cases of open major abdominal surgery under neuraxial anesthesia have been collected in a few centers, but none of the series was laparoscopic. This article is a series of 84 patients undergoing abdominal surgery, partly for neoplasms, operated in laparoscopy and neuraxial anesthesia. Depending on the type of intervention, especially in the intra-abdominal operating region, the anesthetic techniques were different, spinal, epidural or combined. In two cases there was a need to convert the intervention into GA. Most of the patients were classified as ASA II or III. The interventions were carried out with conscious and cooperative patients, with complete abdominal muscle relaxation. No cases required intensive postoperative care. In the COVID era, neuraxial anesthesia represents a significant opportunity to avoid the risk of respiratory contamination for the person operating anesthesia.