Humidified Compared With Dry, Heated Carbon Dioxide at Laparoscopy to Reduce Pain

Abstract

II-2.

Intraperitoneal Adhesions After Open or Laparoscopic Abdominal Procedure: An Experimental Study in the Rat

“…Many studies have shown that short-duration ( < 3 hours) laparoscopic procedures, with cold-dry CO 2 insufflations, can cause peritoneal alterations and result in numerous detrimental outcomes, including postoperative adhesion formation. [30][31][32][33][34] It is supposed that when fibrinolytic activity decreases, the process of adhesion formation does not depend on the type of surgery anymore, but evolves on its own account. The benefits of heated humidified CO 2 insufflations (37°C and 95% relative humidity, physiological condition) have been reported to include less hypothermia, less postoperative pains, shortened recovery room stay, better convalescence, less tumor spread and growth, and less adhesion formation.…”

Bupivacaine use in the Insuflow® device during laparoscopic cholecystectomy: results of a prospective randomized double-blind controlled trial

“…Patients 18 and over were considered for the study. Study exclusion criteria for safety and standardization included (1) pregnancy, (2) previous upper abdominal surgery, (3) known allergy to bupivacaine, (4) suspected common bile duct stones, and (5) chronic pain syndrome or chronic narcotic use. Sample size was estimated at 25 patients per group to achieve 80% power to detect a significant difference in pain scores with a 5% level of significance.…”

“…The heating element reaches a maximum temperature of approximately 120°F; gas insufflates at 95°F and 95% humidity. Several studies have demonstrated decreased postoperative pain using this device [2][3][4][5][6]. We also routinely inject bupivacaine at trocar sites to decrease incisional pain.…”

Method of water nebulization used to prevent heat loss during laparoscopic surgery matters

“…Despite that the focus of this study was temperature loss, the authors discuss postoperative pain and use two references, neither of which reached statistical significance, and then reference pain studies that used the Insuflow Ò device that did show significance but left out two others and one that was published after this paper [11][12][13].…”