The effects of isothermic or hypothermic carbondioxide pneumoperitoneum on arterial blood gases

OBJECTIVE: To investigate the effects of isothermic or hypothermic carbon dioxide used for pneumoperitoneum during laparoscopic cholecystectomy on blood gases.

METHODS: Between 2004 and 2006, 62 patients (American Society of Anesthesiologists grade I, II, and III for elective laparoscopic cholecystectomy) (age between 18 and 70 years), were enrolled in this prospective randomized study. The patients were divided into 2 groups. In the isothermic group, 37 degree celcius carbon dioxide was used, and 21 degree celcius carbon dioxide was used in hypothermic group. Core body temperature at esophagus and skin temperature were measured at 10-minute intervals beginning just before insufflation and during pneumoperitoneum. Blood arterial pH, arterial carbon dioxide pressure, arterial oxygen pressure, and bicarbonate values were measured just before insufflation, at 30 minutes of pneumoperitoneum, and 30 minutes after desufflation.

RESULTS: The mean skin body temperature was significantly higher in the isothermic group than the hypothermic group, no significant difference was observed in core body temperature and blood arterial pH, arterial carbon dioxide pressure, arterial oxygen pressure, and bicarbonate values.

CONCLUSION: Warming insufflated carbon dioxide in laparoscopy does not affect blood gases.