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J Am Assoc Gynecol Laparosc. 1999 Aug;6(3):289-95.

Measurement of CO(2) hypothermia during laparoscopy and pelviscopy: how cold it gets and how to prevent it.

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  • 1Department of Surgery, Fayette Medical Center, Alabama, USA.

Abstract

STUDY OBJECTIVE:

To evaluate intraabdominal CO(2) temperature during a variety of standard operative laparoscopy procedures with different insufflators (BEI Medical, Snowden & Pencer, Storz Laparoflator, Storz Endoflator, Wolf) and devices to maintain body temperature (Bair Hugger, fluid warmer, Blanketrol blankets).

DESIGN:

Prospective, nonrandomized study (Canadian Task Force classification II-1).

SETTING:

Community hospital in rural Alabama.

PATIENTS:

Sixty-two consecutive patients (53 women, 9 men; average age 56.8 yrs, range 21-94 yrs).

INTERVENTIONS:

Patients underwent standard laparoscopic and pelviscopic procedures during which intraoperative temperature changes in the insufflation system, abdomen, and rectum were measured.

MEASUREMENTS AND MAIN RESULTS:

Carbon dioxide was at room temperature in the insufflation hose ( approximately 23 degrees C). During insufflation, intraabdominal gas temperature decreased to as much as 27.7 degrees C (average 32.7 degrees C) depending on length of operation (23 min-5 hrs 8 min), amount of gas used (12.8-801 L), gas flow (up to 20 L/min), and leakage rate. Preoperative and postoperative temperature comparisons showed no decline in rectal temperature (average +0.18 degrees C) because warming equipment was sufficient.

CONCLUSION:

The decrease in intraoperative intraabdominal gas temperature is remarkable and can potentially harm the patient. It can be limited by restricting gas flow and leakage. In operations longer than 1 hour, substantial core body temperature drop should be prevented with appropriate heating and hydration devices. An insufflator with internal gas heating (Snowden & Pencer) had no significant clinical effect. (J Am Assoc Gynecol Laparosc 6(3):289-295, 1999)

PMID:
10459029
[PubMed - indexed for MEDLINE]
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