Is local anesthesia an affordable alternative to general anesthesia for minilaparoscopy?

Study objectiveTo determine if minilaparoscopy under local anesthesia is at least as reliable and affordable as that performed under general anesthesia.DesignProspective, randomized study (Canadian Task Force classification I).SettingUniversity-affiliated hospital.PatientsOne hundred sixty-four consecutive women evaluated for infertility.InterventionDiagnostic minilaparoscopy performed after women were randomized to receive general or local anesthesia with conscious sedation.Measurements and main resultsLevels of postoperative pain measured by visual analog scale; volume of CO(2) used; length of procedure, complete pelvic evaluation, and hospitalization; complications; and pathologic diagnosis were evaluated. The groups were comparable in age, years of infertility, and symptoms. For women receiving local anesthesia, 5.5% required general anesthesia to complete the procedure. Women in both groups required postoperative analgesics. The groups had no statistically significant differences in pain level 1 hour after the procedure, number of complications, and pelvic pathology. Patients who had local anesthesia required a smaller volume of CO(2) (p <0.01) and their hospitalization was significantly shorter (p <0.01). However, in 15% of these women pelvic visualization was incomplete, compared with 7.2% in the general anesthesia group.ConclusionMinilaparoscopy performed under local anesthesia was as reliable and affordable as when performed under general anesthesia.