Assessing the efficacy of regional anesthesia in reducing intraoperative blood loss during hysterectomy
DOI:
https://doi.org/10.18203/2349-3933.ijam20250369Keywords:
Regional anesthesia, Blood loss, Hysterectomy, Postoperative complications, Gynaecological surgeryAbstract
Background: Hysterectomy, a common gynecological procedure, often involves significant blood loss, making the choice of anesthesia crucial. This study examines the impact of regional versus general anesthesia on intraoperative blood loss and associated complications. To assess the efficacy of regional anesthesia in minimizing intraoperative blood loss and improving postoperative outcomes in hysterectomy patients.
Methods: A prospective cross-sectional study was conducted at the Department of Anaesthesia, Analgesia, and Intensive Care Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, from July 2022 to June 2023. A total of 142 patients undergoing elective hysterectomy were included, with 71 receiving regional anesthesia and 71 receiving general anesthesia. Data on intraoperative blood loss, transfusion rates, and postoperative complications were analyzed.
Results: Patients in the regional anesthesia group experienced significantly lower mean blood loss (410±65 ml) compared to the general anesthesia group (520±75 ml) (p<0.01). Transfusion was required for 17% of regional anesthesia patients versus 31% of those under general anesthesia (p=0.02). Postoperative nausea and vomiting were less frequent in the regional anesthesia group (7% vs 17%, p=0.03).
Conclusion: Regional anesthesia significantly reduces intraoperative blood loss, transfusion needs, and postoperative complications during hysterectomy, promoting better surgical outcomes and patient satisfaction. These findings advocate for the wider adoption of regional anesthesia in elective hysterectomy.
Metrics
References
Moawad NS, Santamaria Flores E, Le-Wendling L, Sumner MT, Enneking FK. Total laparoscopic hysterectomy under regional anesthesia. Obstet Gynecol. 2018;131(6):1008-10. DOI: https://doi.org/10.1097/AOG.0000000000002618
Seon HJ, Lee IH, Choi JS. Anesthetic review of emergency peripartum hysterectomy following cesarean delivery. Korean J Anesthesiol. 2012;63(1):43-7. DOI: https://doi.org/10.4097/kjae.2012.63.1.43
American Society of Anesthesiologists. Hysterectomy: Types, Recovery, Pain Management. Available at: https://madeforthismoment.asahq.org. Accessed on 10 November 2024.
NYSORA. Hysterectomy. Available at: https://www.nysora.com/anesthesia/hysterectomy/. Accessed January 10, 2025.
Modig J, Borg T, Karlström G, Maripuu E, Sahlstedt B. Regional anaesthesia and blood loss: a comparative study of epidural and general anaesthesia in hip operations. Acta Anaesthesiol Scand. 1988;32(3):153-7. DOI: https://doi.org/10.1111/j.1399-6576.1988.tb02842.x
Gurusamy KS, Koti R, Davidson BR. Methods to decrease blood loss during liver resection: a network meta-analysis. Cochrane Database Syst Rev. 2014;(3):10683. DOI: https://doi.org/10.1002/14651858.CD010683
Ijuin A, Hayama T, Sakakibara H. The acceptance to germline gene therapy increased during COVID‐19 pandemic among Japanese medical students. J Obst and Gynaecol Res. 2022 Mar 29;48(6):1495–6. DOI: https://doi.org/10.1111/jog.15246
Ker K, Edwards P, Perel P, Shakur H, Roberts I. Effect of tranexamic acid on surgical bleeding: systematic review and cumulative meta-analysis. BMJ. 2012;344:3054. DOI: https://doi.org/10.1136/bmj.e3054
Henry DA, Carless PA, Moxey AJ, O'Connell D, Stokes BJ, Fergusson DA, et al. Anti-fibrinolytic use for minimising perioperative allogeneic blood transfusion. Cochrane Database Syst Rev. 2011;(3):1886. DOI: https://doi.org/10.1002/14651858.CD001886.pub3
Yang ZG, Chen WP, Wu LD. Effectiveness and safety of tranexamic acid in reducing blood loss in total knee arthroplasty: a meta-analysis. J Bone Joint Surg Am. 2012;94(22):1153-9. DOI: https://doi.org/10.2106/JBJS.K.00873
Kagoma YK, Crowther MA, Douketis J, Bhandari M, Eikelboom J, Lim W. Use of antifibrinolytic therapy to reduce transfusion in patients undergoing orthopedic surgery: a systematic review of randomized trials. Thromb Res. 2009;123(5):687-96. DOI: https://doi.org/10.1016/j.thromres.2008.09.015
Ko R, Massa C, Saraiya N, Cheung EW. Multisystem inflammatory syndrome in children (MIS-C): experiences with a new disease process. J Neurosurg Anesthesiol. 2021;34(1):127–31. DOI: https://doi.org/10.1097/ANA.0000000000000811
Sakata DJ. Carbon dioxide as the other therapeutic carrier gas? Anesthesia & Analgesia. 2022;135(1):60–1. DOI: https://doi.org/10.1213/ANE.0000000000006012
Chiem J, Libaw J, Ehie O. Diversity of anesthesia workforce – why does it matter. Current Opinion in Anaesthesiol. 2022;35(2):208–14. DOI: https://doi.org/10.1097/ACO.0000000000001113
Novak-Jankovič V. Regional anaesthesia in thoracic and abdominal surgery. Acta Clinica Croatica. 2019;14:58. DOI: https://doi.org/10.20471/acc.2019.58.s1.14
Patel A, Zhang M, Liao G, Karkache W, Montroy J, Fergusson DA, et al. A Systematic Review and Meta-Analysis examining the impact of age on perioperative inflammatory biomarkers. Anesthesia & Analgesia. 2021;2:88-9. DOI: https://doi.org/10.1213/ANE.0000000000005832
DeLozier OM, Dream S, Findling JW, Rilling W, Kidambi S, Magill SB, et al. Wide variability in catecholamine levels from adrenal venous sampling in primary aldosteronism. J Surg Res. 2022;277:1–6. DOI: https://doi.org/10.1016/j.jss.2022.03.016
Shankar G, Patel K, Shah J. A comparison of regional anesthesia and general anesthesia in reducing intraoperative blood loss during hysterectomy: A prospective study. J Anesth Clin Res. 2022;13(7):1321-7.
Carter J, Davies J. Carbon footprint of anesthesia: comment. Anesthesiol. 2022;137(1):121. DOI: https://doi.org/10.1097/ALN.0000000000004225
Bernauer U, Bodin L, Chaudhry Q. Issue information. Int J Gynecol Obst. 2022;158(1):1375-6.