Acid–base alterations during laparoscopic abdominal surgery: a comparison with laparotomy

Kwak, Hyun Jeong; Jo, Youn Yi; Lee, K.C.; Kim, Y.B.; Shinn, Helen Ki; Kim, J.Y.

doi:10.1093/bja/aeq185

Cited by 26 publications

(21 citation statements)

References 16 publications

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“…Sample size calculation was performed based on a previous study that reported the core body temperature during laparoscopic abdominal surgery with sevoflurane-remifentanil anesthesia [12]: 90% power to detect a mean difference of 0.4℃ in core body temperature between sevoflurane and propofol anesthesia during prolonged pneumoperitoneum with a SD of 0.4℃ and an alpha level of 0.05 using an independent t-test. And, we calculated that 22 patients would be needed in each group.…”

Section: Methodsmentioning

confidence: 99%

Comparison of the effects of sevoflurane and propofol on core body temperature during laparoscopic abdominal surgery

Kwak

Min

et al. 2011

Korean J Anesthesiol

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BackgroundA decrease in core body temperature caused by heat distribution depends on the anesthetic agent used. The purpose of this study is to investigate the effects of sevoflurane and propofol on core temperature during laparoscopic major abdominal surgery requiring pneumoperitoneum of more than 90 min.MethodsFifty adult patients undergoing laparoscopic major abdominal surgery were randomly assigned to either a sevoflurane group (n = 25) or a propofol group (n = 25). In the sevoflurane group, anesthesia was induced with propofol 2 mg/kg, remifentanil 1.0 µg/kg, and maintained with 0.8-2.0 vol% sevoflurane and 0.1-0.2 µg/kg/min remifentanil. In the propofol group, anesthesia was induced with the effect-site concentration of propofol of 5.0 µg/ml and remifentanil 4 ng/ml, and maintained with the effect-site concentration of propofol of 2-3.5 µg/ml and remifentanil 3-5 ng/ml. Core body temperature was measured with an esophageal stethoscope with a temperature sensor after the start of the pneumoperitoneum (baseline) and at 15-min intervals until completion of surgery.ResultsDuring the study period, core temperature was comparable between the two groups. When compared with baseline values, core temperatures in both groups were significantly decreased 45 min after pneumoperitoneum.ConclusionsThis study demonstrated that in patients undergoing prolonged laparoscopic surgery, a decrease in core body temperature during sevoflurane-remifentanil anesthesia was not different than propofol-remifentanil anesthesia, and the incidence of hypothermia of the two groups did not differ.

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Section: Methodsmentioning

confidence: 99%

Comparison of the effects of sevoflurane and propofol on core body temperature during laparoscopic abdominal surgery

Kwak

Min

et al. 2011

Korean J Anesthesiol

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“…The carbon dioxide pneumoperitoneum causes an increase in abdominal pressure and carbon dioxide absorption through the peritoneal serosa, which can cause hypercarbia and respiratory acidosis. 7 This patient's morbidity associated with her mesh removal may have been secondary to the prolonged use of the laparoscopic technique.…”

Section: Discussionmentioning

confidence: 99%

Rectal Mesh Erosion After Robotic Sacrocolpopexy

Hirai¹,

Bohrer²,

Ruel³

et al. 2013

Female Pelvic Medicine &Amp; Reconstructive Surgery

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We report an unusual case of rectal mesh erosion presenting 16 months after robotic sacrocolpopexy. The patient initially underwent a robotic sacrocolpopexy, lysis of adhesions, midurethral sling, and posterior colporrhaphy for symptomatic grade 2 pelvic organ prolapse and urodynamic stress incontinence. Her postoperative recovery was uneventful. Sixteen months later, an anterior 2 × 2-cm rectal mesh erosion was noted on the colonoscopy performed when she presented with hematochezia.

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“…Based on a previous study [6], a sample size of 12 patients per group was calculated to demonstrate a mean difference in pH of 0.06 with an expected SD of 0.05, using values of α = 0.05 with a power (1-β) of 80%. In order to compensate for an estimated dropout rate of 25%, 15 patients for each group were recruited.…”

Section: Methodsmentioning

confidence: 99%

“…Stewart's physiochemical approach was used to analyze the acid base alteration in this study because the traditional approaches by the Henderson-Hasselbalch equation are often inadequate to explain the complexity of acid-base derangements during laparoscopic surgery [6-8]. …”

Section: Introductionmentioning

confidence: 99%

The effect of heating insufflation gas on acid-base alterations and core temperature during laparoscopic major abdominal surgery

Lee

Kim

Kwak

et al. 2011

Korean J Anesthesiol

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BackgroundCarbon dioxide (CO2) has different biophysical properties under different thermal conditions, which may affect its rate of absorption in the blood and the related adverse events. The present study was aimed to investigate the effects of heating of CO2 on acid-base balance using Stewart's physiochemical approach, and body temperature during laparoscopy.MethodsThirty adult patients undergoing laparoscopic major abdominal surgery were randomized to receive either room temperature CO2 (control group, n = 15) or heated CO2 (heated group, n = 15). The acid-base parameters were measured 10 min after the induction of anesthesia (T1), 40 min after pneumoperitoneum (T2), at the end of surgery (T3) and 1 h after surgery (T4). Body temperature was measured at 15-min intervals until the end of the surgery.ResultsThere were no significant differences in pH, PaCO2, the apparent strong ion difference, the strong ion gap, bicarbonate ion, or lactate between two groups throughout the whole investigation period. At T2, pH was decreased whereas PaCO2 was increased in both groups compared with T1 but these changes were not significantly different. Body temperatures in the heated group were significantly higher than those in the control group from 30 to 90 min after pneumoperitoneum.ConclusionsThe heating of insufflating CO2 did not affect changes in the acid-base status and PaCO2 in patients undergoing laparoscopic abdominal surgery when the ventilator was set to maintain constant end-tidal CO2. However, the heated CO2 reduced the decrease in the core body temperature 30 min after the pneumoperitoneum.

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Acid–base alterations during laparoscopic abdominal surgery: a comparison with laparotomy

Cited by 26 publications

References 16 publications

Comparison of the effects of sevoflurane and propofol on core body temperature during laparoscopic abdominal surgery

Comparison of the effects of sevoflurane and propofol on core body temperature during laparoscopic abdominal surgery

Rectal Mesh Erosion After Robotic Sacrocolpopexy

The effect of heating insufflation gas on acid-base alterations and core temperature during laparoscopic major abdominal surgery

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