Journal of Korean Biological Nursing Science

  • 제19권2호
  • /
  • Pages.76-85
  • /
  • 2017
  • /
  • 2383-6415(pISSN)
  • /
  • 2383-6423(eISSN)
한국기초간호학회 (Korean society of Biological Nursing Science)
권호 표지
DOI QR코드

DOI QR Code

복강경 수술에서 기복제 이산화탄소의 37℃ 가온이 수술 중 체온, 수축기압 및 심박동수와 산염기 균형에 미치는 영향

Effects of 37℃ Carbon Dioxide Pneumoperitoneum on Core Body Temperature, Systolic Blood Pressure, Heart Rate and Acid-Base Balance: A Randomized Double-blind Controlled Trial

  • 투고 : 2017.03.12
  • 심사 : 2017.04.07
  • 발행 : 2017.05.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Purpose: The purpose of this study was to compare the effects of $21^{\circ}C\;CO_2$ and $37^{\circ}C\;CO_2$ pneumoperitoneum on body temperature, blood pressure, heart rate, and acid-base balance. Methods: Data were collected at a 1300-bed university hospital in Incheon, from February through September 2012. A total of 74 patients who underwent laparoscopic colectomy under general anesthesia with desflurane were randomly allocated to either a control group or an experimental group. The control group received $21^{\circ}C\;CO_2$ pneumoperitoneum; the experimental group received $37^{\circ}C\;CO_2$ pneumoperitoneum. The pneumoperitoneum of the two groups was under abdominal pressure 15 mmHg. Body temperature, systolic blood pressure, heart rate and acid-base balance were assessed at 30 minutes and 90 minutes after pneumoperitoneum, and again at 30 minutes after arriving at the Post Anesthesia Care Unit. Results: Body temperature in the $37^{\circ}C\;CO_2$ pneumoperitoneum group was significantly higher (F= 9.43, p< .001) compared to the $21^{\circ}C\;CO_2$ group. However, there were no statistically significant differences in systolic blood pressure (p= .895), heart rate (p= .340), pH (p= .231), PaCO2 (p= .490) and HCO3- (p= .768) between the two groups. Conclusion: Pneumoperitoneum of $37^{\circ}C\;CO_2$ is effective for the increase of body temperature compared to pneumoperitonium of $21^{\circ}C\;CO_2$, and it does not result in a decrease of blood pressure, heart rate or acid-base imbalance.

키워드

참고문헌

  1. Park SJ, Lee KY, Lee SH. Laparoscopic surgery for colorectal cancer in Korea: Nationwide Data from 2008-2013. The Journal of Minimally Invasive Surgery. 2015;18(2);39-43. http://dx.doi.org/10.7602/jmis.2015.18.2.39
  2. Backlund M, Kellokumpu I, Scheinin T, von Smitten K, Tikkanen I, Lindgren L. Effect of temperature of insufflated CO2 during and after prolonged laparoscopic surgery. Surgical Endoscopy. 1998;12(9);1126-1130. https://doi.org/10.1007/s004649900798
  3. Huang C, Huang R, Jiang T, Huang K, Cao J, Qiu Z. Laparoscopic and open resection for colorectal cancer: an evaluation of cellular immunity. BMC Gastroenterology. 2010;28(10);127. http://dx.doi.org/10.1186/1471-230X-10-127
  4. Savel RH, Balasubramanya S, Lasheen S, Gaprindashvili T, Arabov E, Fazylov RM, et al. Beneficial effects of humidified, warmed carbon dioxide insufflation during laparoscopic bariatric surgery: A randomized clinical trial. Obesity Surgery. 2005;15(1);64-69. http://dx.doi.org/10.1381/0960892052993530
  5. Menes T1, Spivak H. Laparoscopy: Searching for the proper insufflation gas. Surgical Endoscopy. 2000;14(11);1050-1056.http://dx.doi.org/10.1007/s004640000216
  6. Davis SS, Mikami DJ, Newlin M, Needleman BJ, Barrett MS, Fries R, et al. Heating and humidifying of carbon dioxide during pneumoperitoneum is not indicated: a prospective randomized trial. Surgical Endoscopy. 2005;20(1);153-158. http://dx.doi.org/10.1007/s00464-005-0271-x
  7. Kongsayreepong S, Chaibundit C, Chadpaibool J, Komoltri C, Suraseranivongse S, Suwannanonda P, et al. Predictor of core hypothermia and the surgical intensive care unit. Anesthesia and Analgesia. 2003;96(3);826-833. http://dx.doi.org/10.1213/01.ANE.0000048822.27698.28
  8. Kwak HJ, Min SK, Yi IK, Chang YJ, Kim JY. Comparison of the effects of sevoflurane and propofol on core body temperature during laparoscopic abdominal surgery. Korean Journal of Anesthesiology. 2011;61(2);133-137. http://dx.doi.org/10.4097/kjae.2011.61.2.133
  9. Kim EJ, Yoon H. Preoperative factors affecting the intraoperative core body temperature in abdominal surgery under general anesthesia: An observational cohort. Clinical Nurse Specialist. 2014;28(5);268-276. http://dx.doi.org/10. 1097/NUR.0000000000000069 https://doi.org/10.1097/NUR.0000000000000069
  10. Lee S, Yoon H. Factors affecting intraoperative body temperature in surgical patients with laparotomy under general anesthesia. Journal of Korean Biological Nursing Science. 2015;17(3); 236-244. http://dx.doi.org/10.7586/jkbns.2015. 17.3.236
  11. Kumar S1, Wong PF, Melling AC, Leaper DJ. Effects of perioperative hypothermia and warming in surgical practice. International Wound Journal. 2005;2(3); 193-204. http://dx.doi.org/10.1111/j.1742-4801.2005.00102.x
  12. Kasai T, Hirose M, Matsukawa T, et al. Preoperative blood pressure and catecholamines related to hypothermia during general anesthesia. Acta Anaesthesiologica Scandinavica. 2003;47(2):208-212. http://dx.doi.org/10.1034/j.1399-6576.2003.00048.x
  13. Ott DE. Laparoscopic hypothermia. Journal of Laparoendoscopic Surgery. 1991;1(3);127-131. https://doi.org/10.1089/lps.1991.1.127
  14. Nguyen NT, Furdui G, Fleming NW, Lee SJ, Goldman CD, Singh A, Wolfe BM. Effect of heated and humidified carbon dioxide gas on core temperature and postoperative pain: A randomized trial. Surgical Endoscopy. 2002;16(7);1050-1054. http://dx.doi.org/10.1007/s00464-001-8237-0
  15. Sammour T, Kahokehr A, Hayes J, Hulme-Moir M, Hill AG. Warming and humidification of insufflation carbon dioxide in laparoscopic colonic surgery: Adouble-blinded randomized controlled trial. Annals of Surgery. 2010;251(6); 1024-1033. http://dx.doi.org/10.1097/SLA.0b013e3181d77a25
  16. Ott DE. Correction of laparoscopic insufflation hypothermia. Journal of Laparoendoscopic Surgery. 1991;1(4);183-186. https://doi.org/10.1089/lps.1991.1.183
  17. Farley DR, Greenlee SM, Larson DR, Harrington JR. Double-blind, prospective, randomized study of warmed, humidified carbon dioxide insufflation vs standard carbon dioxide for patients undergoing laparoscopic cholecystectomy. Archives Surgery. 2004;139(7);739-743. http://dx.doi.org/10.1001/archsurg.139.7.739
  18. Peng Y1, Zheng M, Ye Q, Chen X, Yu B, Liu BJ. Heated and humidified CO2 prevents hypothermia, peritoneal injury, and intra-abdominal adhesions during prolonged laparoscopic insufflations. Journal of Surgical Research. 2009; 151(1);40-47. http://dx.doi.org/10.1016/j.jss.2008.03.039
  19. Bashirov E, Cetiner S, Emre M, Seydaliyeva T, Alic V, Daglioglu K, et al. A randomized controlled study evaluating the effects of the temperature of insufflated CO2 on core body temperature and blood gases (an experimental study). Surgical Endoscopy. 2007;21(10); 1820-1825. http://dx.doi.org/10.1007/s00464-007-9295-8
  20. Yeh CH, Kwok SY, Chan MK, Tjandra JJ. Prospective, case-matched study of heated and humidified carbon dioxide insufflation in laparoscopic colorectal surgery. Colorectal Disease. 2007;9(8);695-700. http://dx.doi.org/10.1111/j.1463-1318.2007.01339.x
  21. Park, JD. The effect of warmed carbon dioxide insufflation on the body temperature and acid-base parameters during laparoscopic surgery [master's thesis]. Incheon: University of Gachon; 2007. p. 1-29.
  22. Lee KC, Kim JY, Kwak HJ, Lee HD, Kwon IW. The effect of heating insufflation gas on acid-base alterations and coretemperature during laparoscopic major abdominal surgery. Korean Journal of Anesthesiology. 2011;61(4);275-280. http://dx.doi.org/10.4097/kjae.2011.61.4.275
  23. Ho HS1, Saunders CJ, Gunther RA, Wolfe BM. Effector of hemodynamics during laparoscopy: CO2 absorption or intra-abdominal pressure? Journal of Surgical Research. 1995;59(4);497-503. http://dx.doi.org/10.1006/jsre.1995.1198
  24. Sefr R, Puszkailer K, Jagos F. Randomized trial of different intraabdominal pressures and acid-base balance alterations during laparoscopic cholecystectomy. Surgical Endoscopy. 2003;7(6);947-950. http://dx.doi.org/10.1007/s00464-002-9046-9
  25. Safran DB, Orlando R 3rd. Physiologic effects of pneumoperitoneum. The American Journal of Surgery. 1994;167(2);281-286. http://dx.doi.org/10.1016/ 0002-9610(94)90094-9
  26. Gebhardt H1, Bautz A, Ross M, Loose D, Wulf H, Schaube H. Pathophysiological and clinical aspects of the CO2 pneumoperitoneum (CO2-PP). Surgical Endoscopy. 1997;11(8);864-867. https://doi.org/10.1007/s004649900473
  27. Nguyen NT, Wolfe BM. The physiologic effects of pneumoperitoneum in the morbidly obese. Annals of Surgery. 2005;241(2);219-226. http://dx.doi.org/10. 1097/01.sla.0000151791.93571.70 https://doi.org/10.1097/01.sla.0000151791.93571.70
  28. Stannett V. The transport of gases in synthetic polymeric membranes-An historic perspective. Journal of Membrane Science. 1978;3(2);97-115. http://dx.doi.org/10.1016/S0376-7388(00)83016-1
  29. National Institute for Health and Clinical Excellence. The management of inadvertent perioperative hypothermia in adults. Clinical Practice Guidelines. National Collaborating Centre for Nursing and Supportive Care. London: National Collaborating Centre for Nursing and Supportive Care. 2008. p. 1-567
  30. Kwak HJ, Jo YY, Lee KC, Kim YB, Shinn HK, Kim JY. Acid-base alterations during laparoscopic abdominal surgery: A comparison with laparotomy. British Journal of Anesthesia, 2010;105(4);442-447. http://dx.doi.org/10.1093/bja/aeq185

피인용 문헌

  1. Factors Influencing Intra-Operative Body Temperature in Laparoscopic Colectomy Surgery under General Anesthesia: An Observational Cohort vol.19, pp.3, 2017, https://doi.org/10.7586/jkbns.2017.19.3.123
  2. 복강경하 자궁근종절제술 후 적용한 온열요법이 가스 통증, 수술 후 회복력 및 체온불편감에 미치는 효과 vol.25, pp.1, 2017, https://doi.org/10.4069/kjwhn.2019.25.1.4