Anesthetic Considerations for Laparoscopic Surgery

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Abstract
The ideal anesthetic technique for laparoscopy should minimize the risk of cardiopulmonary complications while providing adequate amnesia, analgesia, and muscle relaxation with rapid recovery. Local anesthesia is best reserved for short procedures involving gentle manipulation and cooperative patients. Spinal or epidural anesthesia is not commonly used because of concerns about respiratory compromise or diaphragmatic irritation brought on by abdominal insufflation. Therefore, laparoscopic procedures are most commonly performed with general anesthesia. Total intravenous anesthesia may have some advantages over inhalational techniques, and among the latter, nitrous oxide is controversial because it may increase the gas volume in the bowel and the incidence of postoperative nausea and vomiting.