The Effect of Humidified and Heated Carbon Dioxide During Laparoscopic Surgury on Post Operative Pain and Incidence of Hypothermia

Essay by yvemorganUniversity, Master'sA+, August 2006

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INTRODUCTION

This assignment will review recent articles pertaining to the use of humidifiers for insufflation of Carbon Dioxide (CO2) in conjunction with laparoscopic surgery. It will discuss the results of the review in relation to clinical practice and will address how the information gained will be used to enhance patient care.

Humidifiers are designed to humidify the CO2 to body temperature allowing the gas to be saturated with water vapour maintaining normal physiological conditions within the intra-abdominal cavity throughout the operation. The idea being that this reduces post operative pain, shortens recovery time and time to return to normal activities, and may lead to a reduction in the risk of other complications such as adhesions and hypothermia (Fisher and Paykel 2005).

At present at MercyAscot where I am employed as a student PNSA humidified gas is not utilised in laparoscopic procedures. The aim of this literature review is to ascertain if humidifiers are beneficial to patient outcome, and should they be implemented at MercyAscot.

CLINICAL OVERVIEW

During laparoscopic surgery cold dry CO2 gas continuously flows into the abdominal cavity creating a pneumoperitoneum allowing a space for surgery to be performed. CO2 is used as it does not support combustion, is cost effective and it is soluble (Fisher and Paykel 2005).

The peritoneum is an organ with unique properties, not designed to cope with variable conditions such as the introduction of cold dry gas. Due to this any change in the environment will have an impact, the larger the deviation from the normal intraabdominal conditions, the larger the effect. Thus the nature of the gas (cold and dry) and the extent of the exposure to this can be a factor in causing tissue damage (Fisher and Paykel 2005).

Insufflation using CO2 during laparoscopic surgery has the same exposure effect as open...