Groene P, Gündogar U, Hofmann-Kiefer K, Ladurner R. Influence of insufflated carbon dioxide on abdominal temperature compared to oesophageal temperature during laparoscopic surgery.
Surg Endosc 2020;
35:6892-6896. [PMID:
33263179 PMCID:
PMC8599343 DOI:
10.1007/s00464-020-08196-x]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 11/17/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND
Body core temperature is an important vital parameter during surgery and anaesthesia. It is influenced by several patient-related and surgery-related factors. Laparoscopy is considered beneficial in terms of a variety of parameters, for example, postoperative pain and length of hospital stay. Non-humidified, non-warmed insufflated CO2 applied during laparoscopy is standard of care. This prospective observational trial therefore evaluates the impact of non-humidified CO2 at room temperature on abdominal temperature and its correlation to body core temperature.
METHODS
Seventy patients undergoing laparoscopic surgery were included in this prospective observational study. Temperature was measured oesophageal and abdominal before induction of anaesthesia (T1), right before skin incision (T2), 15 min, 30 min and 60 min after skin incision. All patients were treated according to actual guidelines for perioperative temperature measurement.
RESULTS
Body core temperature and abdominal temperature correlated moderately (r = 0.6123; p < 0.0001). Bland-Altman plot for comparison of methods showed an average difference of 0.4 °C (bias - 0.3955; 95% agreement of bias from - 2.365 to 1.574). Abdominal temperature further decreased after establishing pneumoperitoneum (T2: 36.2 °C (35.9/36.4) to T5: 36.1 °C (35.6/36.4); p < 0.0001), whereas oesophageal temperature increased (T2: 36.2 °C (35.9/36.4) to 36.4 °C (36.0/36.7); p = 0.0296). Values of oesophageal and abdominal measurement points differed at T4 (36.3 °C (36.0/36.6) vs. 36.1 °C (35.4/36.6); p < 0.0001) and T5 (36.4 °C (36.0/36.7) vs. 36.1 °C (35.6/36.4) p = 0.0003).
CONCLUSION
This prospective observational trial shows the influence of insufflated, non-humidified carbon dioxide at room temperature on abdominal temperature during laparoscopic surgery. We show that carbon dioxide applied at these conditions decreases abdominal temperature and therefore might be a risk factor for perioperative hypothermia.
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