title: Effect of Retroperitoneal Lavage with Normal Saline Containing Adrenaline on Carbon Dioxide Absorption in Patients Undergoing Retroperitoneal Laparoscopic Surgery.
abstract: OBJECTIVE
  To determine the effect of lavage with adrenaline solution on CO2 absorption during retroperitoneal laparoscopic surgery.
  
  
  METHODS
  Sixty patients scheduled to undergo retroperitoneal laparoscopic surgery were divided into an AD group (lavage with normal saline containing adrenaline [1:500,000], n = 30) and an NS group (lavage with normal saline only, n = 30). After the establishment of artificial pneumoperitoneum and before the start of the operation, the retroperitoneal space was irrigated with 300 mL of normal saline with or without adrenaline, depending on the group. The lavage fluid was aspirated after 3 minutes. Heart rate (HR), mean arterial pressure (MAP), blood oxygen saturation (SpO2), partial pressure of O2 (PaO2), partial pressure of CO2 (PaCO2), and end-tidal CO2 partial pressure (PETCO2) were recorded before the lavage (T0) and at 10, 30, 60, 90, and 120 minutes (T1-T5, respectively) after the lavage. The CO2 output (VCO2) was calculated, and the incidence of intraoperative arrhythmia and postoperative complications (e.g., headache, palpitations, irritation) was determined.
  
  
  RESULTS
  HR, MAP, SpO2, PaO2, PaCO2, PETCO2, and VCO2 at T0 did not significantly differ between the groups (P > .05). HR, PaCO2, PETCO2, and VCO2 at T1-T5 were lower in the AD group than in the NS group (P < .05). The incidence of intraoperative arrhythmia and postoperative complications was lower in the AD group than in the NS group (P < .05).
  
  
  CONCLUSIONS
  Lavage with normal saline containing adrenaline (1:500,000) reduced CO2 absorption during retroperitoneal laparoscopic surgery, prevented hypercapnia, and decreased intra- and postoperative complications.
authors.affiliation: Department of Anesthesiology, People's Hospital of Zhengzhou University , Zhengzhou, People's Republic of China .
authors.forename: Yong-Feng
authors.initials: YF
authors.lastname: Zhu
authors.affiliation: Department of Anesthesiology, People's Hospital of Zhengzhou University , Zhengzhou, People's Republic of China .
authors.forename: Fan-Min
authors.initials: FM
authors.lastname: Meng
mesh_terms: D000328:Adult; D000368:Aged; D002245:Carbon Dioxide / Q000378:metabolism*; D004338:Drug Combinations; D004837:Epinephrine / Q000494:pharmacology*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011312:Pressure; D012187:Retroperitoneal Space; D012965:Sodium Chloride / Q000494:pharmacology*; D007507:Therapeutic Irrigation / Q000379:methods; D013520:Urologic Surgical Procedures / Q000379:methods; D055815:Young Adult
chemical_list: D004338:Drug Combinations; D002245:Carbon Dioxide; D012965:Sodium Chloride; D004837:Epinephrine