Ambulatory laparoscopic gynecological surgery in Africa: feasibility
Nzoghe Nguema, P.; Ogowet Igumu, N.; Pither, S.; Ngaka Nsafu, D.
Journal de Gynecologie Obstetrique et Biologie de la Reproduction 30(5): 462-466
2001
ISSN/ISBN: 0368-2315 PMID: 11598560 Document Number: 538103
We report a prospective survey conduced between March 1998 and February 1999 among 100 women classes ASA I and II who underwent laparoscopic surgery for gynecological disorders under general anesthesia. Among these laparoscopies 85 (85%) were performed for operative purposes and 12 (10.7%) for diagnostic purposes. Minimal monitoring was used (no capnography) so prophylacti fluid loading with 0.9% saline was used before insufflation to reduce hemodynamic changes induced by abdominal overpressure and to avoid potential massive air embolism. Insufflation pressure was limited to 14 mmHg. The main agent used for all procedures was propofol. Mean duration of the procedures was 55 minutes. There were no cases of complications or delayed recovery. Complete exsufflation by abdominal compression at the end of the procedures induced minimal abdominal pain and scapulalgia. Ketoprofen as effective postoperatively. Twenty-five patients (25%) complained of nausea and vomiting in the recovery room and were treated effectively with metoclopramide. All patients were discharged and accompanied to their home six hours later after a well-tolerated light meal. The postoperative course was uneventful.