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The clinical impact of warmed insufflation carbon dioxide gas for laparoscopic cholecystectomy

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Background: Reports suggest that the insufflation of cold gas to produce a pneumoperitoneum for laparoscopic surgery can lead to an intraoperative decrease in core body temperature and increased postoperative pain.

Methods: In a randomized controlled trial with 20 patients undergoing laparoscopic cholecystectomy, the effect of insufflation using carbon dioxide gas warmed to 37°C (group W) was compared with insufflation using room-temperature cold (21°C) gas (group C). Intraoperative body core and intra-abdominal temperatures were determined at the beginning and end of surgery. Postoperative pain intensity was evaluated using a visual analog scale and recording the consumption of analgesics.

Results: There were no significant group-specific differences during the operation, neither in body temperature (group W: 36.1 ± 0.4°C vs group C: 35.7 ± 0.6°C) nor in intra-abdominal temperature (group W: 35.9 ± 0.3°C vs group C: 35.6 ± 0.6°C). Postoperatively, the two groups did not differ in pain susceptibility and need of analgesics.

Conclusion: The use of carbon dioxide gas warmed to body temperature to produce a pneumoperitoneum during short-term laparoscopic surgery has no clinically important effect.

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Received: 13 August 1999/Accepted: 24 September 1999/Online publication: 9 August 2000

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Saad, S., Minor, I., Mohri, T. et al. The clinical impact of warmed insufflation carbon dioxide gas for laparoscopic cholecystectomy. Surg Endosc 14, 787–790 (2000). https://doi.org/10.1007/s004640010060

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  • Key words: Cholecystectomy — Hypothermia — Laparoscopy — Pneumoperitoneum