Lower costs, shorter hospital stays: Less morbidity with sedation for microlaparoscopy. (Gynecology).

SAN DIEGO -- Microlaparoscopy performed on sedated patients caused less morbidity in the evaluation and treatment of suspected early-stage endometriosis than microlaparoscopy using general anesthesia or conventional laparoscopy in a study of 50 patients.

Women who underwent microlaparoscopy under sedation reported less pain during the first 6 days after surgery; less nausea, vomiting, and oropharyngeal pain; shorter hospital stays; and a quicker return to normal activities, compared with patients in the other two groups, Dr. Mauricio S. Abrao reported at the World Congress on Endometriosis.

The group that had microlaparoscopy under sedation also had the lowest hospital costs, he said at the meeting sponsored by the World Endometriosis Society and the American Society for Reproductive Medicine.

Pain levels were measured by visual analog scale scores three times on the day of surgery and daily for 6 days postoperatively When the two microlaparoscopy groups were compared, scores were lower in the group that had sedation at two of the three time points.

Pain scores in either microlaparoscopy group were much less than half those reported by the conventional laparoscopy group, said Dr. Abrao of Sao Paulo (Brazil) University.

The patients underwent the surgery because of chronic pelvic pain, dysmenorrhea, or deep dyspareunia resistant to clinical treatment. Three 2-mm trocars were used in microlaparoscopy.

Conventional laparoscopy involved a 10-mm trocar and two 5-mm auxiliary trocars.