The comparison of the oxidative stress effects of different gases and intra-abdominal pressures in an experimental rat model.
BACKGROUND
Laparoscopy is used for almost all types of abdominal surgery because of its advantages, which include shorter postoperative hospital stay. However, pneumoperitoneum used to facilitate the visual field has severe metabolic, hemodynamic, and inflammatory consequences depending on the pressure level and the gas used. Helium (He), an inert gas, has been recommended for establishment of pneumoperitoneum since it does not alter the blood pH and PCO(2). Yet the oxidative response after He insufflation remains unknown. This study was undertaken to compare the levels of free radical production and antioxidant status following He and CO(2) pneumoperitoneum at different intra-abdominal pressure values.


METHODS
The subjects were 40 Sprague-Dawley male rats randomized to the following groups: He 10 (n = 8) was subjected to He pneumoperitoneum at 10 mm Hg for 60 minutes; He 15 (n = 8) was subjected to He pneumoperitoneum at 15 mm Hg for 60 minutes; CO(2) 10 (n = 8) was subjected to CO(2) pneumoperitoneum at 10 mm Hg for 60 minutes; CO(2) 15 (n = 8) was subjected to CO(2) pneumoperitoneum at 15 mm Hg for 60 minutes; and Control (n = 8) was subjected to sham operation without pneumoperitoneum. At the end of the experiment blood samples were obtained and plasma malondialdehyde, carbonyl, and sulphydryl levels were measured.


RESULTS
CO(2) pneumoperitoneum produced higher malondialdehyde and carbonyl responses and sulphydryl consumption compared to He, especially at 15 mm Hg (P = 0.01, P = 0.01, and P = 0.059, respectively).


CONCLUSIONS
Helium seems to limit the postoperative oxidative response following laparoscopy.
Yilmaz
Sezein
S
Faculty of Medicine, General Surgery, Afyon Kocatepe University, Afyon, Turkey. syilmaz@aku.edu.tr
Polat
Coscun
C
Kahraman
Ahmet
A
Koken
Tulay
T
Arikan
Yuksel
Y
Dilek
Osman N
ON
Gökçe
Ozcan
O
D000005:Abdomen / Q000502:physiology*; D000818:Animals; D000975:Antioxidants / Q000032:analysis; D002245:Carbon Dioxide / Q000008:administration & dosage*; D005609:Free Radicals / Q000378:metabolism; D006371:Helium / Q000008:administration & dosage*; D015227:Lipid Peroxidation; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D018384:Oxidative Stress; D011028:Pneumoperitoneum, Artificial; D011312:Pressure; D051381:Rats; D017207:Rats, Sprague-Dawley; D017392:Thiobarbituric Acid Reactive Substances
D000975:Antioxidants; D005609:Free Radicals; D017392:Thiobarbituric Acid Reactive Substances; D002245:Carbon Dioxide; D006371:Helium; D008315:Malondialdehyde