Prospective randomized trial of heated humidified versus cold dry carbon dioxide insufflation during laparoscopic gastric bypass
| Autor: | Michael Williams, J.K. Champion |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
Insufflation
Adult Male medicine.medical_specialty Abdominal pain Hot Temperature Laparoscopic gastric bypass Gastric Bypass law.invention Randomized controlled trial law Statistical significance Paralysis Medicine Humans Prospective Studies Prospective cohort study Pain Postoperative business.industry Hypothermia Carbon Dioxide Middle Aged Surgery Obesity Morbid Cold Temperature Treatment Outcome Anesthesia Female Laparoscopy medicine.symptom business Follow-Up Studies |
| Zdroj: | Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery. 2(4) |
| ISSN: | 1550-7289 |
| Popis: | Background The replacement of cold dry carbon dioxide with heated humidified gas for insufflation during complex laparoscopic procedures has been reported to decrease hypothermia and peritoneal cell desiccation, with a resultant decrease in postoperative pain and narcotic use and a shortened recovery, but may prevent the paralysis of the peritoneal polymorphonuclear cell cytokine cascade and add to the cost of the procedure. We report our outcomes comparing carbon dioxide insufflation with different characteristics during laparoscopic gastric bypass. Methods Fifty consecutive patients were randomized to undergo laparoscopic gastric bypass with either cold-dry or heated-humidified carbon dioxide insufflation. Statistical analysis of variance between groups was determined by Levine's t test with the Greenhouse-Geisser correction, at a significance level of P Results The two groups were similar for preoperative gender, age, weight, body mass index, and baseline C-reactive protein. The intraoperative room and patient core temperature, liters of insufflation used, lens cleanings, operating time, recovery room time, and narcotics used were not significantly different. The postoperative subjective analog shoulder pain score was significantly less (P = .025) for the heated-humidified group at 18 hours, but not at 6, 12, 24, or 48 hours. The abdominal pain scores and overall narcotic use, postoperative C-reactive protein, and length of stay were not significantly different between the two groups. Conclusion Heated-humidified insufflation resulted in a transient reduction in subjective shoulder pain at 18 hours postoperatively, but no reduction in abdominal pain or narcotics used. We were unable to verify any clinically significant difference between the two groups comparing heated-humidified and cold-dry insufflation after laparoscopic gastric bypass. |
| Databáze: | OpenAIRE |
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