Liječnički vjesnik (Feb 2021)
Anesthesia techniques in outpatient surgery for procedures due to cervical dysplasia – experiences in Sestre milosrdnice UHC
Abstract
Today, anesthesia and analgesia are so safe and effective that surgical procedures for cervical dysplasia can be performed as day surgery. Anesthesia techniques in day surgery are related to significantly less morbidity and mortality. Until 2015, all surgical procedures for cervical dysplasia at the Sestre milosrdnice University Hospital Center in Zagreb were performed under general anesthesia, with the average length of hospital stay longer than 30 hours and shorter than 72 hours. We have conducted retrospective research at the Department of Gynecology and Obstetrics for the period from January 2015 to December 2019, as cone biopsy procedures have been performed under local anesthesia since then. We have studied the frequency of local and regional anesthesia in relation to the type of cone biopsy, frequency of the type of anesthesia in relation to the age group and risk assessment of the patient undergoing anesthesia, and length of hospital stay in relation to the type of surgical procedure. In the period from 2015 to 2019, there was a steady increase in the share of local anesthesia in the total number of large loop excisions of the transformation zone (LLETZ) by 36.46 % (49/104 procedures in 2015 compared to 112/134 procedures in 2019). From October 2018, when the spinal block was introduced as a method of anesthesia for the cold knife cone biopsy, until December 2019, the share of the spinal block in the total number of cold knife cone biopsies increased by 17.29 % (2/65 procedures in 2018 compared to 11/54 procedures in 2019). Our research provides an analysis of the difference in the incidence of anesthesia techniques depending on the type of surgical procedure, risk assessment and age of the patient undergoing anesthesia for cervical dysplasia, and length of hospital stay in relation to the type of cone biopsy.
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