Comparative analysis of spinal anesthesia versus general anesthesia in single-port access laparoscopic adnexal surgery: a propensity score matching study

Abstract

This study evaluated the safety and efficacy of spinal anesthesia as an alternative to general anesthesia in single-port access (SPA) laparoscopic adnexal surgeries. 110 patients were recruited and, after propensity score matching, 63 (general anesthesia: 42, spinal anesthesia: 21) were analyzed. During surgery, the Trendelenburg position was limited to 15 degrees, and CO2 pressure maintained at 8-12 mmHg. Postoperative pain and nausea/vomiting scores were assessed up to 48 h post-surgery. No significant differences in patient characteristics were noted between groups. Immediately postoperative, the spinal anesthesia group showed significantly lower pain scores (4.74 +/- 1.48 in spinal anesthesia vs. 0.67 +/- 0.66 in general anesthesia; p <.001) and nausea/vomiting scores (p =.027). Intraoperative hypotension occurred in both groups (28.6% in spinal anesthesia vs. 33.3% in general anesthesia; p =.774) and was managed with ephedrine. No other intraoperative or postoperative complications were noted. Conclusively, spinal anesthesia is a viable and safe option for SPA laparoscopic salpingo-oophorectomy, effectively reducing immediate postoperative pain and nausea/vomiting.