The clinical impact of warmed insufflation carbon dioxide gas for laparoscopic cholecystectomy

Background: Reports suggest that the insufflation of cold gas to produce a pneumoperitoneum for laparoscopic surgery can lead to an intraoperative dec rease in core body temperature and increased postoperative pain. Methods: In a randomized controlled trial with 20 patients undergoing lapar oscopic cholecystectomy, the effect of insufflation using carbon dioxide ga s warmed to 37 degrees C (group W) was compared with insufflation using roo m-temperature cold (21 degrees C) gas (group C). Intraoperative body core a nd intra-abdominal temperatures were determined at the beginning and end of surgery. Postoperative pain intensity was evaluated using a visual analog scale and recording the consumption of analgesics. Results: There were no significant group-specific differences during the op eration, neither in body temperature (group W: 36.1 +/- 0.4 degrees C vs gr oup C: 35.7 +/- 0.6 degrees C) nor in intra-abdominal temperature (group W: 35.9 +/- 0.3 degrees C vs group C: 35.6 +/- 0.6 degrees C). Postoperativel y, the two groups did not differ in pain susceptibility and need of analges ics. Conclusion: The use of carbon dioxide gas warmed to body temperature to pro duce a pneumoperitoneum during shortterm laparoscopic surgery has no clinic ally important effect.