Anesthetic Consideration for Laparoscopic Surgery

Minimally invasive surgical procedures aim to minimize the tissue trauma but still achieve a satisfactory therapeutic result. Tissue trauma is significantly less than conventional open procedure. Laparoscopy is the process of inspecting the abdominal cavity through an endoscope. Carbon dioxide is commonly used to insufflate the abdominal cavity to facilitate the view. The surgical advantages of laparoscopic operations are the reduction of postoperative pain, significant cost savings and more rapid return to normal activities. Pathophysiological changes including the alteration of cardiorespiratory function occur after carbon dioxide pneumoperitoneum and extremes of patient positioning. In addition, the sequential effects of anesthesia combine to produce a characteristic hemodynamic response. A thorough understanding of these physiological changes is fundamental for optimal anesthetic care. General anesthesia and controlled ventilation using balanced anesthesia technique including several intravenous and inhalation agents with the use of muscle relaxant shows a rapid recovery and cardiovascular stability. Peripheral nerve blocks, neuraxial anesthesia and local anesthesia infiltration were considered as safe and effective in some laparoscopic operations. This report considers the pathophysiological changes during laparoscopy, preprocedure assessment, patient monitoring, anesthetic techniques, intraoperative complications and postoperative period.