Insufflation with humidified and heated carbon dioxide in short-term laparoscopy: a double-blinded randomized controlled trial.
BACKGROUND
We tested the hypothesis that warm-humidified carbon dioxide (CO2) insufflation would reduce postoperative pain and morphine requirement compared to cold-dry CO2 insufflation.


METHODS
A double-blinded, randomized, controlled trial was conducted to compare warm, humidified CO2 and cold-dry CO2. Patients with benign uterine diseases were randomized to either treatment (n = 48) or control (n = 49) group during laparoscopically assisted vaginal hysterectomy. Primary endpoints of the study were rest pain, movement pain, shoulder-tip pain, and cough pain at 2, 4, 6, 24, and 48 hours postoperatively, measured by visual analogue scale. Secondary outcomes were morphine consumption, rejected boli, temperature change, recovery room stay, and length of hospital stay.


RESULTS
There were no significant differences in all baseline characteristics. Shoulder-tip pain at 6 h postoperatively was significantly reduced in the intervention group. Pain at rest, movement pain, and cough pain did not differ. Total morphine consumption and rejected boli at 24 h postoperatively were significantly higher in the control group. Temperature change, recovery room stay, and length of hospital were similar.


CONCLUSIONS
Warm, humidified insufflation gas significantly reduces postoperative shoulder-tip pain as well as morphine demand. This trial is registered with Clinical Trial Registration Number  DRKS00003853 (German Clinical Trials Register (DRKS)).
Clinic of Gynecology, Obstetrics and Gynecological Oncology, University Hospital for Gynecology, Pius-Hospital Oldenburg, School of Medicine and Health Sciences, Carl von Ossietzky University of Oldenburg, 26121 Oldenburg, Germany.
Anja
A
Herrmann
Clinic of Gynecology, Obstetrics and Gynecological Oncology, University Hospital for Gynecology, Pius-Hospital Oldenburg, School of Medicine and Health Sciences, Carl von Ossietzky University of Oldenburg, 26121 Oldenburg, Germany.
Rudy Leon
RL
De Wilde
D000328:Adult; D002245:Carbon Dioxide / Q000008:administration & dosage*; D005260:Female; D006358:Hot Temperature; D006801:Humans; D007327:Insufflation; D010535:Laparoscopy / Q000009:adverse effects; D009020:Morphine / Q000008:administration & dosage; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy* / Q000503:physiopathology
D002245:Carbon Dioxide; D009020:Morphine