title: Warmed, humidified carbon dioxide insufflation versus standard carbon dioxide in laparoscopic cholecystectomy: a double-blinded randomized controlled trial.
abstract: BACKGROUND
  During laparoscopic cholecystectomy (LCHE), the insufflation with warmed and humidified carbon dioxide (CO2) may reduce postoperative pain. The aim of the study was to evaluate the positive effects of heated and humidified carbon dioxide gas on patients with regard to postoperative pain after LCHE.
  
  
  METHODS
  This is a prospective, randomized, double-blinded, controlled clinical trial. 148 patients (female = 98, male = 50) scheduled for elective LCHE were randomized into two groups: receiving either heated humidified carbon dioxide, or standard gas. Intraoperative core temperature was measured. The perioperative management was identical for both groups. Postoperative pain intensity was assessed using a visual analog pain scale, and the amount of analgesic consumption was recorded. The postoperative pain management was also standardized and equal for both groups.
  
  
  RESULTS
  67 out of 148 received standard gas (group A), and 81 received warmed, humidified gas (group B). The groups were comparable demographically. The amount of analgesic consumption was recorded. Intraoperative core temperature was significant higher in group B than in group A. Pain was significantly less in group B (p = 0.025) 6 h postoperatively. On the first postoperative day, no significant difference in pain between the two groups was detectable (p = 0.437).
  
  
  CONCLUSIONS
  The use of warmed and humidified carbon dioxide during LCHE reduces postoperative pain at the day of operation.
authors.affiliation: 2nd Surgical Department, Academic Teaching Hospital, Ludwig Boltzmann Institute for Operative Laparoscopy, Linz General Hospital, Krankenhausstrasse 9, 4021, Linz, Austria, bettina.klugsberger@akh.linz.at.
authors.forename: Bettina
authors.initials: B
authors.lastname: Klugsberger
authors.forename: Markus
authors.initials: M
authors.lastname: Schreiner
authors.forename: Alexander
authors.initials: A
authors.lastname: Rothe
authors.forename: Dietmar
authors.initials: D
authors.lastname: Haas
authors.forename: Peter
authors.initials: P
authors.lastname: Oppelt
authors.forename: Andreas
authors.initials: A
authors.lastname: Shamiyeh
mesh_terms: D000328:Adult; D000368:Aged; D002245:Carbon Dioxide / Q000008:administration & dosage*; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D004311:Double-Blind Method; D005260:Female; D006358:Hot Temperature; D006801:Humans; D006813:Humidity; D007327:Insufflation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000453:epidemiology* / Q000517:prevention & control; D011446:Prospective Studies; D013696:Temperature
chemical_list: D002245:Carbon Dioxide
references.citation: Surg Endosc. 1999 Feb;13(2):101-5
references.pmid: 9918606
references.citation: Surg Endosc. 1999 Nov;13(11):1110-4
references.pmid: 10556449
references.citation: Surg Endosc. 2001 Jun;15(6):579-81
references.pmid: 11591944
references.citation: Chirurg. 1994 Mar;65(3):200-8
references.pmid: 7910792
references.citation: Surg Laparosc Endosc Percutan Tech. 2008 Dec;18(6):539-46
references.pmid: 19098656
references.citation: Surg Endosc. 2009 Jun;23(6):1393-7
references.pmid: 19118436
references.citation: J Surg Res. 2009 Jan;151(1):40-7
references.pmid: 18639246
references.citation: Surg Endosc. 2000 Sep;14(9):787-90
references.pmid: 11000355
references.citation: Br J Surg. 2008 Aug;95(8):950-6
references.pmid: 18618870
references.citation: Chirurg. 2003 Apr;74(4):282-9
references.pmid: 12719869
references.citation: JSLS. 1998 Oct-Dec;2(4):321-9
references.pmid: 10036122