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Title: | Addition of nitrous oxide and oxygen to carbon dioxide pneumoperitoneum during laparoscopic surgery for pain reduction: A double-blinded randomized controlled trial | Authors: | VERGUTS, Jasper Soors, Eline CALLEBAUT, Ina EVERS, Stefan VANDENBRANDE, Jeroen Ceulemans, Angelique SMEETS, Wouter Al Tmimi, Layth STESSEL, Bjorn |
Issue Date: | 2024 | Publisher: | WILEY | Source: | BJOG (Oxford. Print), | Status: | Early view | Abstract: | Objective: To examine if peritoneal conditioning with an altered insufflation gas mixture is associated with reduced postoperative pain intensity compared to the standard insufflation gas (i.e., 100% CO2). Design: A prospective, single-centre, randomized, double-blind, superiority trial was performed. Setting: This study was conducted between 4 April 2019 and 10 February 2022 at the Jessa Hospital, Hasselt, Belgium. Population: Patients scheduled for elective gynaecologic laparoscopic surgery. Methods: Seventy-four patients scheduled for elective gynaecologic laparoscopic surgery were randomised to receive either the standard insufflation gas with 100 CO2 (n = 37; control group) or the altered gas mixture of 86% CO2, 10% N2O and 4% O-2 (n = 37; experimental group). Main Outcome Measures: Postoperative pain was assessed at 4, 8 and 24 hours after surgery and on postoperative day (POD) 7 by an 11-point Numeric Rating Scale, with 0 indicating no pain and 10 indicating worst imaginable pain. Results: No significant differences were found between the control and experimental groups regarding postoperative pain at 4, 8 and 24 h after surgery, as well as on POD7. In addition, the median (25% and 75%) total amount of IV piritramide consumption during the first 24 h after surgery was not significantly different between groups (control group: 18.0 [10.0, 27.0] mg vs. experimental group: 17.0 [10.0, 34.0] mg, p = 0.62). Conclusion: The alternative insufflation gas mixture comprising 86% CO2, 10% N2O and 4% O-2 used for the pneumoperitoneum during gynaecologic laparoscopic surgery does not appear to reduce postoperative pain compared to the standard insufflation gas of 100% CO2. | Notes: | Verguts, J (corresponding author), Jessa Hosp, Dept Obstet & Gynaecol, Stadsomvaart 11, B-3500 Hasselt, Belgium. jasper.verguts@jessazh.be |
Keywords: | insufflation gas;laparoscopic surgery;pain | Document URI: | http://hdl.handle.net/1942/43641 | ISSN: | 1470-0328 | e-ISSN: | 1471-0528 | DOI: | 10.1111/1471-0528.17939 | ISI #: | WOS:001294764200001 | Category: | A1 | Type: | Journal Contribution |
Appears in Collections: | Research publications |
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