Hypothermia induced by laparoscopic insufflation

Abstract

Hypothermia is a common postsurgical problem, yet information documenting the impact of laparoscopy on perioperative heat balance is scarce. This paper quantifies the changes in core temperature over a 3-h period of high-flow CO2 insufflation in a randomized, controlled trial of six pigs. Each animal was anesthetized and studied on three occasions under standardized conditions, acting as its own control via insufflation with no gas compared with insufflation by cold gas and warmed gas. Insufflation of CO2 gas at high-flow rates over a prolonged period of time results in a significant fall in core temperature. The provision of warmed rather than cold insufflated gas confers no protection against changes in core temperature during laparoscopic surgery due to the small amount of heat required to warm the gas to body temperature. A much greater effect is the latent heat required to saturate the insufflated gas. Most of the hypothermic effect is due to this, and could be minimized by humidifying the flow.

Effects of laparoscopy on the cardiorespiratory system of brown brocket deer (Mazama gouazoubira) anesthetized with ketamine/ xylazine/ midazolam combination and isoflurane

“…It was recorded that laparoscopic insufflation of abdominal cavity could induce hyperthermia in pigs and human beings (Bessell et al 1995). However, the significant reduction of the rectal temperature found between P1, P2 and P3 in this study occurred independent of the laparoscopy treatment, and caused hypothermia (35 o C) during the recovery of one animal.…”

Effect of heated and humidified carbon dioxide gas on core temperature and postoperative pain

“…Carbon dioxide (CO 2 ) pneumoperitoneum during laparoscopic surgery is generally delivered at room temperature (20±21°C) and at relatively low humidity. Contact of this dry, ambient CO 2 gas with the large peritoneal surface can induce hypothermia [3,4]. Prolonged laparoscopic operations (>3 h) require higher volumes of insuation gas, thereby increasing the risk of intraoperative hypothermia.…”

Development of a new membrane-type heated humidifier for laparoscopic surgery

“…Conventional pneumoperitoneum by cold CO 2 gas results in hypothermia [2,6]. In general, CO 2 gas is insufflated at below 25°C at a flow rate of 10 L/min [6].…”