Appendektomia laparoskopowa przeprowadzona w znieczuleniu przewodowym – opis przypadku

Introduction: Laparoscopic appendectomy is performed conventionally under general anaesthetization. It has been assumed that this type of anaesthesia with accompanying patient relaxation is the optimal way to provide sufficient operating space and appropriate analgesic effect for surgical techniques that require the creation of pneumoperitoneum. Based on the reports in the literature and the case described in this paper, it can safely be stated that the current approach to anaesthesia in laparoscopic procedures is becoming less and less justified.Case presentation: The paper presents the case of a young woman with no internal diseases who was diagnosed with acute appendicitis and qualified for laparoscopic appendectomy. The American Society of Anaesthesiology scale was rated 1 and it was decided to perform the laparoscopy under ductal anaesthesia. Both the procedure and anaesthesia went without complications, and additionally the patient could avoid the risk of potential complications resulting from general anaesthetization and muscle relaxation.Results: The development of surgical techniques and the increasing experience of laparoscopic surgeons make the current laparoscopic procedures much shorter than the duration of the muscle relaxants, and the analgesic effect of ductal anaesthesia turns out to be totally sufficient. In addition, the case presented shows that lack of patient relaxation does not negatively affect the course of the procedure itself.Conclusions: Operative treatment of acute abdominal disorders by laparoscopic surgery under ductal anaesthesia is feasible and safe for patients without significant internal diseases. The case presented in this paper justifies the need for more extensive use of this method of anaesthesia during laparoscopic procedures of acute abdominal disorders, and the final value of ductal anaesthetization during surgical treatment with the laparoscopic technique should be determined on the basis of prospective studies comparing the use of both methods of anaesthesia.