J Invest Surg. 2025 Dec;38(1):2594554. doi: 10.1080/08941939.2025.2594554. Epub 2025 Dec 11.
ABSTRACT
OBJECTIVE: This study aims to unravel the clinical effects of total intravenous anesthesia (TIVA) versus combined intravenous-inhalational anesthesia, each with ultrasound-guided transversus abdominis plane (TAP) block, in gynecologic laparoscopic surgery.
METHODS: In this prospective randomized controlled trial, 100 patients undergoing gynecologic laparoscopic surgery were randomly assigned to either a control group (balanced inhalation anesthesia + TAP block) or an observation group (TIVA + TAP block) (n = 50 each). Postoperative recovery, pain scores (VAS at 2, 6, 12, 24, and 48 h), hemodynamics (SpO2, heart rate, SBP) at key surgical stages, and stress markers (cortisol, PGE2), and complications were recorded.
RESULTS: Baseline characteristics were comparable. The observation group showed faster spontaneous respiration recovery, awakening, and extubation (all p < 0.05), though ambulation, flatus, and hospital stay did not differ (p > 0.05). VAS scores were lower in the observation group at all time points (p < 0.05). Hemodynamics remained stable in both groups. Postoperative cortisol and PGE2 rose in both groups but were lower in the observation group (p < 0.05). Nausea/vomiting incidence was reduced with TIVA (p < 0.05).
CONCLUSION: TIVA combined with ropivacaine TAP block accelerates early recovery, improves analgesia, attenuates surgical stress, and reduces nausea/vomiting.
PMID:41378841 | DOI:10.1080/08941939.2025.2594554
