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Hypoxaemia During Gynaecological Laparoscopy Under Local Anaesthesia and Sedation


Simbo D. Amanor-Boadu
Adesina Oladokun
Ayodele O. Arowojolu
Akin-Tunde Odukogbe

Abstract

Context: Laparoscopy is a procedure with significant potential for hypoxaemia due to the respiratory changes accompanying pneumoperitoneum and the Trendelenberg position used. Hypoxaemia may be critical when the procedure is conducted under local anaesthesia and conscious sedation.


Objective: The aim of this study was to determine the extent to which hypoxaemic episodes occurred during gynaecological laparoscopy performed under conscious sedation.


Study Design, Setting and Subjects: This was a cross-sectional study of consecutive patients undergoing investigative laparoscopy at the University College Hospital, Ibadan. Informed consent was obtained from patients and they were prepared for the procedure on a day-care basis. The demographic data and vital signs were recorded. Pentazocine (60 mg) and diazepam (10 mg) were administered intravenously.


Main Outcome Measures: The respiratory rate, pulse rate, blood pressure and oxygen saturation were measured pre-, intra-, and post-operatively.


Results: Thirty-two patients were recruited into the study. They had no intercurrent medical diseases. Mean age was 33 years (SD 4.2) and mean Body Mass Index (BMI) was 24.49 (SD 2.87). Oxygen saturation was normal in every patient pre-sedation. Post sedation, 19 (54%) of the patients desaturated in the period before surgical stimulation. Oxygen saturation remained between 90% and 95% in 6 (19 %) patients intraoperatively. There were no postoperative episodes of desaturation. There was no correlation between the BMI and the degree of desaturation.


Conclusion: A significant degree of desaturation occurs during gynaecologic laparoscopy under pentazocine and diazepam sedation. It is recommended that oxygen should be administered to all patients during the procedure.


Key Words: Gynaecological Laparoscopy, Sedation, Hypoxaemia.


[Trop J Obstet Gynaecol, 2002, 19: 4-7].

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eISSN: 0189-5117