Comparison between local anaesthesia with remifentanil and total intravenous anaesthesia for operative hysteroscopic procedures in day surgery

Br J Anaesth. 2012 Feb;108(2):245-53. doi: 10.1093/bja/aer337. Epub 2011 Nov 23.

Abstract

Background: This study aimed at comparing total i.v. anaesthesia (TIVA) with monitored anaesthesia care (MAC) during day-surgery operative hysteroscopy regarding: operation time, time to mobilization and discharge, and patient satisfaction.

Methods: Ninety-one healthy women were randomized to MAC with paracervical local anaesthesia and remifentanil or to TIVA with propofol and remifentanil. Time from arrival to leaving the operating theatre, time from arrival in the recovery room to mobilization and discharge readiness, and patient satisfaction with MAC and TIVA were observed.

Results: Time from arrival to leaving the operating theatre showed no significant difference between groups (P=0.6). The time to mobilization {MAC: 53 min [inter-quartile range (IQR) 40-83], TIVA: 69 min (IQR 52-96) (P=0.017)} and the total time from arrival to discharge readiness [MAC: 118 min (IQR 95-139), TIVA: 138 (IQR 120-158) (P=0.0009)] were significantly reduced for patients in the MAC group. More patients in the MAC group 45 (91.8%) than in the TIVA group 24 (64.9%) responded positively to the question: would you like to receive the same kind of anaesthesia for a similar procedure in the future? (P=0.003).

Conclusions: Paracervical local anaesthesia combined with remifentanil is suitable for operative hysteroscopy in day surgery.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Ambulatory Surgical Procedures / methods
  • Analgesics, Opioid / administration & dosage*
  • Anesthesia Recovery Period
  • Anesthesia, Intravenous / methods*
  • Anesthesia, Local / methods*
  • Conscious Sedation / methods
  • Drug Administration Schedule
  • Female
  • Humans
  • Hypnotics and Sedatives / administration & dosage
  • Hysteroscopy / methods*
  • Middle Aged
  • Patient Satisfaction
  • Piperidines / administration & dosage*
  • Remifentanil

Substances

  • Analgesics, Opioid
  • Hypnotics and Sedatives
  • Piperidines
  • Remifentanil