Incidence of conversion to general anesthesia and need for intravenous supplementation in patients undergoing gynecologic laparoscopic procedures under spinal anesthesia: an observational study

Laparoscopic procedures, increasingly used in gynaecology, have traditionally been performed under general anaesthesia (GA). However, with the growth of day-care surgeries, spinal anaesthesia (SA) is being used more widely due to advantages such as rapid recovery, reduced postoperative pain, minimal respiratory compromise, and better haemodynamic stability. Despite these benefits, SA may be associated with complications including shoulder pain, inadequate analgesia, nausea, vomiting, and hypotension. Failed or inadequate spinal blocks may lead to intraoperative intravenous supplementation or conversion to GA, which carries a higher risk of complications compared to either technique alone.

This prospective observational study aims to determine the incidence and reasons for conversion from SA to GA in elective gynaecological laparoscopic surgeries. A total of 180 ASA I–II female patients aged 18–60 years undergoing procedures at KIMS, Hubli will be evaluated. Standard preoperative preparation and spinal anaesthesia with 0.5% hyperbaric bupivacaine will be administered. Intraoperative parameters, requirement for intravenous supplementation, timing of drug administration, complications, and factors such as anaesthesiologist and surgeon experience will be recorded. Data will be analysed using appropriate statistical tests and multivariable regression to identify predictors of conversion. The study aims to improve understanding of SA reliability and factors influencing its failure in gynaecologic laparoscopy.