الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Laparoscopy is the process of inspecting the abdominal cavity
through an endoscope. Carbon dioxide is most universally used to
insufflate the abdominal cavity to facilitate the view. However, several
pathophysiological changes occur after carbon dioxide insufflation as
pneumoperitoneum and extremes of patient positioning.
Regional anesthesia including (Peripheral nerve blocks and
neuraxial block) is considered as safe alternative to general anesthesia for
outpatient laparoscopy without associated respiratory depression. Local
anesthesia infiltration has shown to be effective and safe in
microlaparoscopy for limited and precise gynecologic procedures.
However, intravenous sedation is sometimes required.
With the realization of smaller incisions, better cosmesis, less postoperative pain, same-day surgery, speedier postoperative recovery, and the potential for reduced complications, laparoscopic approaches have all but replaced the traditional laparotomic alternatives for certain commonly performed surgical procedures.
Laparoscopy is not risk free. The complications associated with laparoscopy include those related to surgical instrumentation, creation of the pneumoperitoneum, and patient positioning.
Now ultrasounds have been shown to decrease local anesthetic volume and improve the success of the block. Ultrasound-guidance enhances efficacy and safety. The main disadvantages are the cost of equipment and the need for adequate training of anesthesiologists before clinical application of ultrasound-guided blocks.