{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T02:52:15Z","timestamp":1789786335968,"version":"4.0.1"},"reference-count":30,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T00:00:00Z","timestamp":1718323200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Fulbright Specialist Program"},{"name":"EVER Pharma, Austria"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Objective: This prospective study investigated the feasibility of performing laparoscopic pelvic surgery under spinal anesthesia and analyzed the intraoperative side effects, like pain, nausea, and vomitus, of 915 patients. Methods: The implementation and performance of laparoscopic surgery under local anesthesia on 915 patients (out of a total of 3212 who underwent laparoscopic pelvic surgery under spinal anesthesia) were analyzed in relation to BMI (body mass index), obesity, pain during surgery, amount of intraperitoneal mmHg CO2 gas pressure, and surgical complications. Results: BMI &gt; 30, intra-abdominal adhesions, increased duration of the operation, bleeding, and increased intraperitoneal CO2 pressure were statistically significant as the main causes of pain during laparoscopic surgery under spinal anesthesia. Underweight patients, on the other hand, had less pain when intra-abdominal pressure increased compared to those of normal weight. The appearance of pain, nausea, and vomitus occurred in 10.3% of patients, and these events were easy to manage and treat. They did not affect the surgeon\u2019s work or the course of the operation. Conclusions: In light of these observations, we are proposing spinal anesthesia for laparoscopic surgery as the first choice in patients who have no contraindications. To the best of our knowledge, this clinical study constitutes the largest clinical observation and dataset concerning spinal anesthesia in laparoscopic pelvic surgery. Trial registration: ISRCTN38987, 10 December 2019.<\/jats:p>","DOI":"10.3390\/jpm14060633","type":"journal-article","created":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T03:52:53Z","timestamp":1718337173000},"page":"633","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Gynecological Laparoscopic Surgeries under Spinal Anesthesia: Benefits and Challenges"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1459-2727","authenticated-orcid":false,"given":"Attila L.","family":"Major","sequence":"first","affiliation":[{"name":"Femina Gynecology Centre, CH-1205 Geneva, Switzerland"},{"name":"Faculty of Sciences and Medicine, University of Fribourg, CH-1700 Fribourg, Switzerland"},{"name":"Department of Gynecology and Obstetrics, Urgench Branch of Tashkent Medical Academy, Urgench 220100, Uzbekistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kudrat","family":"Jumaniyazov","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Urgench Branch of Tashkent Medical Academy, Urgench 220100, Uzbekistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruslan","family":"Jabbarov","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Urgench Branch of Tashkent Medical Academy, Urgench 220100, Uzbekistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehdi","family":"Razzaghi","sequence":"additional","affiliation":[{"name":"Department of Mathematics, Computer Science, and Digital Forensics, Bloomsburg University, Bloomsburg, PA 17815, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivanna","family":"Mayboroda","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Regional Hospital of Yverdon-les-Bains, CH-1400 Yverdon, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,14]]},"reference":[{"key":"ref_1","unstructured":"Jumaniyazov, K. (2021, January 3). Spinal Anesthesia in Laparoscopic Surgeries. Proceedings of the International Conference on \u201cLaparoscopic Surgery Using Spinal Anesthesia in Gynecology during COVID-19 Period\u201d Urgench Branch of Tashkent Medical Academy, Urgench, Uzbekistan."},{"key":"ref_2","first-page":"832","article-title":"Advantages and disadvantages of regional anesthesia for cesarean section. A review","volume":"30","author":"Spielman","year":"1985","journal-title":"J. Reprod. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1097\/ALN.0000000000002629","article-title":"Adverse events and factors associated with potentially avoidable use of general anesthesia in cesarean deliveries","volume":"130","author":"Guglielminotti","year":"2019","journal-title":"Anesthesiology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1053\/S1084-208X(03)00038-7","article-title":"Regional anesthesia for cesarean section","volume":"7","author":"Riley","year":"2003","journal-title":"Tech. Reg. Anesth Pain. Manag."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Major, A.L., Jumaniyazov, K., Yusupova, S., Jabbarov, R., Saidmamatov, O., and Mayboroda-Major, I. (2021). Laparoscopy in Gynecologic and Abdominal Surgery in Regional (Spinal, Peridural) Anesthesia, the Utility of the Technique during COVID-19 Pandemic. Medicines, 8.","DOI":"10.3390\/medicines8100060"},{"key":"ref_6","first-page":"55","article-title":"The Effect of Trendelenburg Posture on Sensory Block Level in Spinal Anesthesia with Intrathecal Hyperbaric Bupivacaine for Hernia Repair","volume":"1","author":"Shahriari","year":"2015","journal-title":"Arch. Anesth. Crit. Care"},{"key":"ref_7","first-page":"133","article-title":"Laparoscopic Surgery Using Spinal Anesthesia","volume":"12","author":"Sinha","year":"2008","journal-title":"JSLS J. Soc. Laparoendosc. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"41","DOI":"10.2147\/LRA.S19979","article-title":"Laparoscopic cholecystectomy under spinal anesthesia: Comparative study between conventional dose and low-dose hyperbaric bupivacaine","volume":"4","author":"Imbelloni","year":"2011","journal-title":"Local Reg. Anesth."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1111\/j.1365-2044.2009.06202.x","article-title":"Regional anaesthesia and pain management","volume":"65","author":"Power","year":"2010","journal-title":"Anaesthesia"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"130S","DOI":"10.1097\/01.AOG\/01.AOG.0000559240.42051.12","article-title":"Minimizing Trendelenburg Position for Laparoscopic Gynecologic Surgery [6L]","volume":"133","author":"Wagner","year":"2019","journal-title":"Obstet. Gynecol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e101","DOI":"10.1111\/anae.14868","article-title":"Advances in regional anaesthesia and acute pain management: A narrative review","volume":"75","author":"Albrecht","year":"2020","journal-title":"Anaesthesia"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1093\/bja\/aeu559","article-title":"Peripheral regional anaesthesia and outcome: Lessons learned from the last 10 years","volume":"114","author":"Kessler","year":"2015","journal-title":"Br. J. Anaesth."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.jclinane.2005.01.013","article-title":"Anesthesia for laparoscopy: A review","volume":"18","author":"Gerges","year":"2006","journal-title":"J. Clin. Anesth."},{"key":"ref_14","first-page":"9","article-title":"Spinal versus general anesthesia for laparoscopic cholecystectomy: A comparative study of cost effectiveness and side effects","volume":"13","author":"Turkstani","year":"2009","journal-title":"Anaesth. Pain Intensive Care"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1177\/000313480407000803","article-title":"Laparoscopic approach reduces likelihood of perioperative complications in patients undergoing adrenalectomy","volume":"70","author":"Gonzalez","year":"2004","journal-title":"Am. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1246","DOI":"10.1213\/ANE.0000000000003668","article-title":"Multimodal General Anesthesia","volume":"127","author":"Brown","year":"2018","journal-title":"Anesth. Analg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"101813","DOI":"10.1016\/j.jogoh.2020.101813","article-title":"Laparoscopic surgery for benign adnexal conditions under spinal anaesthesia: Towards a multidisciplinary minimally invasive approach","volume":"49","author":"Raimondo","year":"2020","journal-title":"J. Gynecol. Obstet. Hum. Reprod."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Major, A.L., Jumaniyazov, K., Yusupova, S., Jabbarov, R., Saidmamatov, O., and Mayboroda-Major, I. (2021). Removal of a Giant Cyst of the Left Ovary from a Pregnant Woman in the First Trimester by Laparoscopic Surgery under Spinal Anesthesia during the COVID-19 Pandemic. Med. Sci., 9.","DOI":"10.3390\/medsci9040070"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"McCullagh, P., and Nelder, J.A. (1983). Generalized Linear Models, Chapman and Hall.","DOI":"10.1007\/978-1-4899-3244-0"},{"key":"ref_20","unstructured":"Rutherford, A. (2001). Introducing ANOVA and ANCOVA: A GLM Approach, Sage Publishing."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Hilbe, J.M. (2009). A Practical Guide to Logistic Regression, CRC Press.","DOI":"10.1201\/9781420075779"},{"key":"ref_22","first-page":"460","article-title":"Neuraxil anesthesia versus general anestesia in laparoscopic cholecystectomie: A systemic review of randomized controlled trials","volume":"10","author":"Memtsa","year":"2018","journal-title":"J. Clin. Med. Res."},{"key":"ref_23","first-page":"1","article-title":"Spinal Anesthesia and Spinal Anesthesia with Subdiaphragmatic Lidocaine in Shoulder Pain Reduction for Gynecological Laparoscopic Surgery: A Randomized Clinical Trial","volume":"2017","author":"Asgari","year":"2017","journal-title":"Pain Res. Manag."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1016\/j.jmig.2008.05.012","article-title":"Pain Relief by Continuous Intraperitoneal Nebulization of Ropivacaine during Gynecologic Laparoscopic Surgery\u2013A Randomized Study and Review of the Literature","volume":"15","author":"Kaufman","year":"2008","journal-title":"J. Minim. Invasive Gynecol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/j.jmig.2013.09.009","article-title":"Laparoscopy in the morbidly obese: Physiologic considerations and surgical techniques to optimize success","volume":"21","author":"Scheib","year":"2014","journal-title":"J. Minim. Invasive Gynecol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1111\/aogs.14477","article-title":"Patients with low body mass index are more likely to develop shoulder pain after laparoscopy","volume":"102","author":"Jiang","year":"2023","journal-title":"Acta Obstet. Gynecol. Scand."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e2022.00082","DOI":"10.4293\/JSLS.2022.00082","article-title":"Vaginal Natural Orifice Transluminal Endoscopic Surgery Revolution: The Next Frontier in Gynecologic Minimally Invasive Surgery","volume":"27","author":"Lerner","year":"2023","journal-title":"JSLS"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1186\/s44158-022-00076-1","article-title":"Opioid sparing effect of intravenous dexmedetomidine in orthopaedic surgery: A retrospective analysis","volume":"2","author":"Donatiello","year":"2022","journal-title":"J. Anesth. Analg. Crit. Care"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Bao, N., Shi, K., Wu, Y., He, Y., Chen, Z., Gao, Y., Xia, Y., Papadimos, T.J., Wang, Q., and Zhou, R. (2022). Dexmedetomidine prolongs the duration of local anesthetics when used as an adjuvant through both perineural and systemic mechanisms: A prospective randomized double-blinded trial. BMC Anesthesiol., 22.","DOI":"10.1186\/s12871-022-01716-3"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1061605","DOI":"10.3389\/fvets.2022.1061605","article-title":"Evaluation of a constant rate intravenous infusion of dexmedetomidine on the duration of a femoral and sciatic nerve block using lidocaine in dogs","volume":"9","author":"Stabile","year":"2023","journal-title":"Front. Vet. Sci."}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/14\/6\/633\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:58:28Z","timestamp":1760108308000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/14\/6\/633"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,14]]},"references-count":30,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2024,6]]}},"alternative-id":["jpm14060633"],"URL":"https:\/\/doi.org\/10.3390\/jpm14060633","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,14]]}}}