Evaluation and Comparison Between General Anesthesia VS Two Types of Combined Anesthesia for Opioid Consumption in Laparoscopic Hysterectomy

Managing post-operative pain is essential to reduce length of stay, complications, mortality, healthcare costs and the risk of readmission to hospital. At the same time, pain treatment, especially with opiod drugs, could cause side effects and worsen the quality of post-operative hospitalization. Furthermore, intrathecal fentanyl may cause an acute tolerance to opioids, and may worsen postoperative analgesia. In literature, some studies underline how the use of regional anesthesia represents an effective solution in pain control. The goal of this study would be to determine whether post-operative analgesic needs and pain levels are increased by mixing intrathecal fentanyl with spinal anesthesia and intrathecal morphine.

Inclusion criteria

• patients over 18 year of age,
• ASA physical status I to III scheduled for laparoscopic hysterectomy (with or without adnexectomy)

Exclusion criteria

• patients with inability to consent,
• patient refusal,
• contraindication to spinal anesthesia (e.g., hemodynamic instability, infection at the surgery site, and neurologic defects such as transverse myelitis, coagulopathies or ongoing anticoagulant therapy),
• known chronic pain syndrome, known
• suspected non- compliance,
• drug, or alcohol abuse ,
• major oncological surgeries,
• allergy to drugs used in the protocol,
• previous chronic use of analgesics
• history of opioid abuse