الفهرس 
Technique of laparoscopic surgeryOnly 14 pages are availabe for public view
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Abstract
The development of minimally invasive surgery has revolutionized surgical procedures, and in the process has influenced the practice of anaesthesia. The aim of this work was to evaluate different anaesthetic regimens and procedures that can be used in this type of minimally invasive techniques. An optimal anaesthetic technique for laparoscopy should provide excellent intraoperative conditions while insuring rapid recovery, low incidence of adverse effect and return to daily activity. General anaesthesia with muscle paralysis and tracheal intubations remains the preferable technique for most laparoscopic procedures. Maintenance with inhalational anaesthesia (e.g. desflurane and sevoflurane) allows rapid recovery as compared with infusion of propofol. Total intravenous anaesthesia using propofol, midazolam, ketamine, fentanyl and vecuronium has been reported for out patient laparoscopy. Short laparoscopic procedure, such as diagnostic laparoscopy, pain mapping, laparoscopy for infertility and tubal legations can be performed under local or regional anaesthesia. Epidural anaesthesia has been used for outpatient gynaecological laparoscopic procedures to reduce complications and shorten recovery time. The high epidural block (T2-T4 levels) is required to abolish the discomfort of surgical stimulation of the upper gastrointestinal structures. The high block produces myocardial depression and reduction in venous return, aggravating the haemodynamic effects of tension pneumoperitoneum.