EFFECT OF TEMPERATURE OF INSUFFLATED CO2 DURING AND AFTER PROLONGED LAPAROSCOPIC SURGERY

Background: Pneumoperitoneum with room temperature carbon dioxide (CO2 ) has been shown to decrease core temperature and urine output. Method s: The effect of 37 degrees C (warm) and room temperature (cool) CO2 p neumoperitoneum on core temperature, urine output, and central hemodyn amics was compared in 26 randomized patients undergoing prolonged lapa roscopic surgery (>90 min). Results: The core temperature (p < 0.05) a nd cardiac index (p < 0.05) were significantly higher after warm than after cool pneumoperitoneum. Urine output was significantly higher dur ing warm (2.3 +/- 1.6 ml/kg/h) than during cool (0.9 +/- 0.7 ml/kg/h) insufflation (p < 0.05). Two of 13 patients with warm and 11 of 13 pat ients with cool pneumoperitoneum needed mannitol to maintain adequate diuresis (p < 0.05). Conclusions: Warm insufflation probably causes a local vasodilation in the kidneys and may be beneficial to patients wi th borderline renal function.