This approach has been design ed to provide adequate analgesia while minimizing exposure to adverse events
Background : Laparoscopic cholecystectomy has advantages over the open procedure for postoperative pain .
However , a systematic review of postoperative pain management in this procedure has not been conducted .
Comparison of immunologic and physiologic effects of CO2 pneumoperitoneum at room and body temperatures
Abstract Background : Prolonged and complex laparoscopic procedures expose patients to large volumes of cool insufflation gas . The aim of this study was to compare the effects of a conventional room temperature carbon dioxide ( CO2 ) pneumoperitoneum with those of a body temperature pneumoperitoneum . Methods : Patients were r and omized to undergo laparoscopic cholecystectomy with a CO2 pneumoperitoneum  warmed to either body temperature ( n= 15 ) or room temperature ( n= 15 ) . The physiologic and immunologic effects of warming the gas were examined by measuring peroperative core and intraperitoneal temperatures , peritoneal fluid cytokine concentrations , and postoperative pain . Results : The mean duration of surgery was 32 min in both groups . Core temperature was reduced in the room temperature group ( mean , 0.42 ° C ; p < 0.05 ) . No reduction in temperature occurred when the gas was warmed . Greater levels of cytokines were detected in peritoneal fluid from the room temperature insufflation group tumor necrosis factor alpha ( TNF-α ) : mean , 10.9 pg/ml vs. 0.42 , p < 0.05 ; interleukin 1 beta ( IL-1β ) : mean , 44.8 pg/ml vs. 15.5 , p < 0.05 ; and IL-6 : mean , 60.4 ng/ml vs. 47.2 . There was no difference in postoperative pain scores or analgesia consumption between the two groups . Conclusions : The authors conclude that intraoperative cooling can be prevented by warming the insufflation gas , even in short laparoscopic procedures . In addition , warming the insufflation gas leads to a reduced postoperative intraperitoneal cytokine response
This approach has been design ed to provide adequate analgesia while minimizing exposure to adverse events
Background : Laparoscopic cholecystectomy has advantages over the open procedure for postoperative pain .
However , a systematic review of postoperative pain management in this procedure has not been conducted .