title: Postoperative drowsiness and emetic sequelae correlate to total amount of carbon dioxide used during laparoscopic cholecystectomy.
abstract: BACKGROUND
  After laparoscopy with carbon dioxide (CO2) insufflation early postoperative recovery is often complicated with drowsiness and postoperative nausea and vomiting (PONV).
  
  
  METHODS
  25 ASA I-II patients undergoing elective laparoscopic cholecystectomy under standardized anaesthesia were studied in a randomized, prospective study. The conventional CO2 pneumoperitoneum was compared with the mechanical abdominal wall lift (AWL) method with minimal CO2 insufflation with special reference to postoperative recovery.
  
  
  RESULTS
  Postoperative drowsiness was of a significantly longer duration with the conventional method (p < 0.001) compared with the AWL technique. There was a positive correlation with the total amount of CO2 used and the duration of drowsiness (r = 0.75, p < 0.01). PONV was seen significantly more often in patients with CO2 insufflation of more than 121 (p < 0.05).
  
  
  CONCLUSIONS
  Avoiding excessive CO2 is beneficial for smoother and more uneventful recovery after laparoscopic cholecystectomy.
authors.affiliation: Department of Anaesthesia, Helsinki University Hospital, University of Helsinki, Finland.
authors.forename: A M
authors.initials: AM
authors.lastname: Koivusalo
authors.forename: I
authors.initials: I
authors.lastname: Kellokumpu
authors.forename: L
authors.initials: L
authors.lastname: Lindgren
mesh_terms: D002245:Carbon Dioxide / Q000008:administration & dosage / Q000627:therapeutic use*; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects* / Q000379:methods; D004305:Dose-Response Relationship, Drug; D006801:Humans; D011028:Pneumoperitoneum, Artificial / Q000009:adverse effects*; D011183:Postoperative Complications / Q000503:physiopathology*; D011446:Prospective Studies; D012894:Sleep Stages; D014839:Vomiting
chemical_list: D002245:Carbon Dioxide