Segmental spinal anesthesia with a two-drug technique in short gynecological laparoscopic surgeries: A case series

Regional anesthesia is beneficial in fast-tracking day care surgeries by avoiding postoperative adverse effects of general anesthetics. Segmental spinal Anesthesia, though underreported, offers targeted neural blockade, minimizing systemic effects and enhancing recovery in ambulatory surgery. This case series describes 10 patients undergoing short-duration gynecological laparoscopic surgeries under segmental spinal anesthesia with a sequential two-drug technique: hyperbaric followed by isobaric levobupivacaine with dexmedetomidine at T9–10 level. All patients achieved effective anesthesia, stable hemodynamics, early ambulation and high satisfaction without complications or conversion to general anesthesia. Given the limited literature, our findings highlight segmental spinal anesthesia with this sequential two-drug technique as a safe, effective, and promising alternative to general anesthesia for short-duration gynaecologic laparoscopic surgeries.