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Beneficial Effects of Humidified, Warmed Carbon Dioxide Insufflation during Laparoscopic Bariatric Surgery: a Randomized Clinical Trial - Obesity Surgery

  • ️Macura, Jerzy M
  • ️Sat Jan 01 2005

Background: Recent data has shown that the use of warmed, humidified carbon dioxide (CO2) insufflation during laparoscopic surgery may be associated with better outcomes. Methods: We performed a randomized, doubleblind, prospective controlled clinical trial of 30 patients undergoing laparoscopic Roux-en-Y gastric bypass (LRYGBP). Patients were randomized into 2 groups. The first group (group 1, n=15) received standard (dry, room temperature) CO2 for insufflation during the surgery, while the second group (group 2, n=15) received warmed (35°C) and humidified (95%) CO2. Patients received postoperative analgesia from morphine delivered via a patient-controlled analgesia (PCA) pump. Pain scores (on a scale of 0 to 10, 0 being no pain and 10 being the worst pain) were measured postoperatively at 3 h, 6 h, 1 day and 2 days. The amount of morphine that was delivered through the PCA was also measured at the same time intervals. Operating-room (OR) time, core temperature, and total hospital length of stay were documented. Results: Postoperative pain as documented by pain scores and narcotic usage were not statistically different in the 2 groups. We demonstrated a statistically significant difference (mean±SD) in OR time (76±16 min vs 101±34 min, P=0.02), total hospital length of stay (3.2±.4 days vs 4.0±.9 days, P=0.01) and end-of-case core temperature (36.2±.5°C vs 35.7±.6°C, P=0.02) in group 2 compared with group 1. Conclusion: The use of warmed, humidified CO2 insufflation in bariatric patients undergoing LRYGBP was not associated with any significant benefit with regards to postoperative pain.

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Authors and Affiliations

  1. Department of Surgery, Maimonides Medical Center, Brooklyn, New York, USA

    Richard H Savel

  2. Department of Surgery, Maimonides Medical Center, Brooklyn, New York, USA

    Shyamasundar Balasubramanya

  3. Department of Anesthesia, Maimonides Medical Center, Brooklyn, New York, USA

    Samy Lasheen

  4. Department of Anesthesia, Maimonides Medical Center, Brooklyn, New York, USA

    Teimuraz Gaprindashvili

  5. Department of Surgery, Maimonides Medical Center, Brooklyn, New York, USA

    Eddie Arabov

  6. Department of Surgery, Maimonides Medical Center, Brooklyn, New York, USA

    Rafael M Fazylov

  7. Department of Surgery, Maimonides Medical Center, Brooklyn, New York, USA

    Richard S Lazzaro

  8. Department of Surgery, Maimonides Medical Center, Brooklyn, New York, USA

    Jerzy M Macura

Authors

  1. Richard H Savel

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  2. Shyamasundar Balasubramanya

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  3. Samy Lasheen

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  4. Teimuraz Gaprindashvili

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  5. Eddie Arabov

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  6. Rafael M Fazylov

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  7. Richard S Lazzaro

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  8. Jerzy M Macura

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Savel, R.H., Balasubramanya, S., Lasheen, S. et al. Beneficial Effects of Humidified, Warmed Carbon Dioxide Insufflation during Laparoscopic Bariatric Surgery: a Randomized Clinical Trial. OBES SURG 15, 64–69 (2005). https://doi.org/10.1381/0960892052993530

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  • Published: 01 January 2005

  • Issue Date: January 2005

  • DOI: https://doi.org/10.1381/0960892052993530