title: The clinical impact of warmed insufflation carbon dioxide gas for laparoscopic cholecystectomy.
abstract: 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 degrees C (group W) was compared with insufflation using room-temperature cold (21 degrees 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 degrees C vs group C: 35.7 +/- 0.6 degrees C) nor in intra-abdominal temperature (group W: 35.9 +/- 0.3 degrees C vs group C: 35.6 +/- 0. 6 degrees C). Postoperatively, the two groups did not differ in pain susceptibility and need of analgesics.
  
  
  CONCLUSIONS
  The use of carbon dioxide gas warmed to body temperature to produce a pneumoperitoneum during short-term laparoscopic surgery has no clinically important effect.
authors.affiliation: Second Department of Surgery, University of Cologne, Ostmerheimer Strasse 200, 51109 Cologne, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Saad
authors.forename: I
authors.initials: I
authors.lastname: Minor
authors.forename: T
authors.initials: T
authors.lastname: Mohri
authors.forename: M
authors.initials: M
authors.lastname: Nagelschmidt
mesh_terms: D000368:Aged; D002245:Carbon Dioxide; D017081:Cholecystectomy, Laparoscopic; D002769:Cholelithiasis / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control; D011028:Pneumoperitoneum, Artificial / Q000379:methods*; D011446:Prospective Studies; D013696:Temperature
chemical_list: D002245:Carbon Dioxide