Carbon dioxide, temperature and laparoscopic cholecystectomy

Laparoscopic procedures have previously been shown to interfere little with respiratory homeostasis. This study was designed to determine whether respiratory homeostasis, as well as temperature, is maintained with longer laparoscopic procedures and cold carbon dioxide insufflation. This study examined 21 American Society of Anesthesiologists status I and II patients undergoing laparoscopic cholecystectomy. A constant minute ventilation (80 mL/kg per min) was instituted prior to peritoneal insufflation and end-tidal carbon dioxide measurements were followed throughout the procedure. Although they showed a small statistically significant increase (32.3 +/- 3.8 to 38.9 +/- 6.0 mmHg, P = 0.0001) they were not of clinical significance. Similarly, rectal temperature measurements showed a statistically, but not clinically, significant fall in temperature over the course of the procedures (36.4 +/- 0.46 to 36.2 +/- 0.35 degrees C, P = 0.0001). The changes in end-tidal carbon dioxide and temperature showed no correlation with the volume or carbon dioxide used. The above findings will, however, require further investigation in both longer procedures and patients with more significant disease.