Bashirov E, Cetiner S, Emre M, Seydaliyeva T, Alic V, Daglioglu K, Ozalevli M, San M, Topcuoglu M S
Department of General Surgery, Mustafa Kemal University School of Medicine, Bagriyanik mah., 31100, Antakya, Hatay, Turkey.
Surg Endosc. 2007 Oct;21(10):1820-5. doi: 10.1007/s00464-007-9295-8. Epub 2007 May 22.
Heated carbon dioxide (CO2) was used for pneumoperitoneum (Pp) to prevent hypothermia. This study aimed to investigate the relationship between the temperature of the insufflated CO2 and blood gases together with the core body temperature (CBT).
A prospective controlled study was performed with 24 pigs weighing approximately 20 kg randomized into four groups of 6 pigs each. A pneumoperitoneum at 12 mmHg of pressure was applied for 60 min with the pig under general anesthesia. The CO2)temperature was 22 degrees C in group 1, 37 degrees C in group 2, and 7 degrees C in group 3. In the "sham" group, pneumoperitoneum was not applied. Arterial blood pH and partial pressure of CO2 (PaCO2) were analyzed before insufflation, every 15 min during the pneumoperitoneum, and 15 min after the desufflation. The CBT was recorded before the insufflation, every 20 min during pneumoperitoneum, and 20 min after the desufflation. Blood gas analyses and CBT records for the "sham" group were performed at the same intervals.
Arterial blood pH gradually decreased during pneumoperitoneum. At the 60th minute of pneumoperitoneum, a minimum decrease in arterial blood pH (0.04; p = 0.027) and a minimum increase in PaCO2 (3.67; p = 0.027) were recorded in group 3, whereas a maximum decrease in arterial blood pH (0.18; p = 0.027) and a maximum increase in PaCO2 (17.17; p = 0.027) were recorded in group 2. There was a significant negative correlation between PaCO2 and arterial blood pH in all the groups (r = -0.993; p < 0.01). The mean values of CBT decreases were statistically significant in all the groups: group 1 (p = 0.023), group 2 (p = 0.026), group 3 (p = 0.026), and "sham" group (p = 0.024).
The changes in PaCO2 were directly proportional and the changes in pH contrarily proportional to the temperature of the insufflated CO2. Significant differences in CBT decreases were found between the groups receiving heated gas and room temperature gas and the groups receiving heated gas and gas below room temperature.
加热二氧化碳（CO₂）用于气腹术（Pp）以预防体温过低。本研究旨在探讨注入的CO₂温度与血气及核心体温（CBT）之间的关系。
进行一项前瞻性对照研究，将24头体重约20千克的猪随机分为四组，每组6头。在全身麻醉下对猪施加12 mmHg压力的气腹术60分钟。第1组CO₂温度为22℃，第2组为37℃，第3组为7℃。“假手术”组未施加气腹术。在充气前、气腹术期间每15分钟以及放气后15分钟分析动脉血pH值和二氧化碳分压（PaCO₂）。在充气前、气腹术期间每20分钟以及放气后20分钟记录CBT。“假手术”组的血气分析和CBT记录在相同间隔进行。
气腹术期间动脉血pH值逐渐降低。在气腹术第60分钟时，第3组记录到动脉血pH值的最小降幅（0.04；p = 0.027）和PaCO₂的最小增幅（3.67；p = 0.027），而第2组记录到动脉血pH值的最大降幅（0.18；p = 0.027）和PaCO₂的最大增幅（17.17；p = 0.027）。所有组中PaCO₂与动脉血pH值之间均存在显著负相关（r = -0.993；p < 0.01）。所有组CBT下降的平均值具有统计学意义：第1组（p = 0.023）、第2组（p = 0.026）、第3组（p = 0.026）和“假手术”组（p = 0.024）。
PaCO₂的变化与注入的CO₂温度成正比，而pH值的变化与之成反比。在接受加热气体和室温气体的组与接受加热气体和低于室温气体的组之间，CBT下降存在显著差异。
