La sterilisation per coelioscopique sous anesthesie locale.
Auteurs : Audra P, Dargent DDate 1984 Juillet-Août, Vol 12, Num 7-8, pp 943-5Revue : Contraception, fertilité, sexualitéType de publication : article de périodique;Laparoscopic sterilization with local anesthesia is almost never done in Europe at present. The authors were moved to undertake use of local anesthesia in an effort to reduce hospital stays to meet the needs of some patients and to put the few available hospital beds to maximal use. The anesthetist sees all patients before the procedure. An electrocardiogram, chest X-ray, and blood work are done. A perfusion of isotonic glucose serum is installed for the procedure, and local anesthesia is achieved with xylocaine 1% with a vasoconstrictor to prevent too rapid diffusion of the xylocaine. The steps in the procedure are the administration of the paracervical block, establishment of the pneumoperitoneum by the posterior vaginal route using C02, administration of cutaneous abdominal anesthesia using the same mixture, anesthetizing of the tube with lidocaine 4%, and sterilization, which may be done by thermocoagulation or mechanical means. Only 9 sterilizations under local anesthesia have been performed by the authors. The total duration of the procedure is about 20 minutes. The pneumoperitoneum has been well tolerated by patients if it does not exceed 2 liters. Only 1 patient was unfit for discharge on the evening of the procedure. The risk of the procedure is decreased because there is no general anesthesia, but some cooperation from the patient is required.