COMPARISON OF LOCAL ANESTHESIA AND CONSCIOUS SEDATION WITH SPINAL ANESTHESIA IN VAGINAL RECONSTRUCTIVE SURGERIES
چکیده
Objective: There are some studies of feasibility and success of vaginal reconstructive surgeries using local anesthesia. The aim of this study was to compare the combination of local anesthesia and conscious sedation with spinal anesthesia for vaginal repair of advanced vaginal prolapse. Methodology: Thirty-eight patients with vaginal prolapse as a prospective, randomized and case-controlled clinical trial were operated upon during one year period under local anesthesia with intravenous sedation or spinal anesthesia. Results: Eighteen women underwent colporraphy, or colpocleisis, using local anesthesia with sedation and 20 patients underwent same procedures using spinal anesthesia. Mean age was 42.18 +/- 11.10 years ( range 27 to 73). No patient was converted to generated anesthesia. None of patients had intra-operative pain scores >1. Incidence of hypotension (0% v. s 55%; p<0.0001), and blood loss (39.17 +/- 13.20 v. s 79.00 +/- 18.25 ml; p<0.0001) were lower in the study patients. Duration of anesthesia, time of discharge from post-operative anesthesia care unit (PACU) and the first request to analgesia were significantly different in two groups. Average hospital stay was not different (p=0.56). All 38 patients were very satisfied with their anesthesia experience (p=0.62). Conclusion: Local anesthesia with sedation can be successfully and safely employed for most vaginal reconstructive surgeries with genital prolapse. This technique is associated with minimal homeostasis and rapid recovery and longer postoperative analgesia.