Laparoscopic surgeries are frequently performed under general anesthesia due to concerns about pneumoperitoneum-associated physiological changes. The use of regional techniques is gaining ground but not without its associated complications. The use of regional anesthesia depends upon the experience and competence of the attending anesthetist. However, a good knowledge of physiological changes and the burden of anesthesia is essential for the attending anesthetist. Most of the changes are associated with the type of gas used for intraperitoneal insufflation and the pressure exerted within the intraperitoneal cavity. Physiological changes are mostly observed in the cardiorespiratory systems.