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Improved outcomes for lap-banding using the Insuflow device compared with heated-only gas.

Benavides R, Wong A, Nguyen H - JSLS (2009 Jul-Sep)

Bottom Line: The humidified-warmed group had statistically significant differences from the other 2 groups with improvement in all end points.The dry-heated group had significantly more pain medication use and increased shoulder and chest pain than the other 2 groups had.Dry-heated gas may cause additional complications as is indicated by the increase in pain medication use and pain intensity.

View Article: PubMed Central - PubMed

Affiliation: Surgery Center of Richardson, Texas, USA. scasey@aigb.com

ABSTRACT

Background and objectives: Preconditioning gas by humidification and warming the pneumoperitoneum improves laparoscopic outcomes. This prevents peritoneal desiccation and detrimental events related to traditional cold-dry gas. Few comparisons have been done comparing traditional cold-dry, heated-only, and humidified-warmed carbon dioxide.

Methods: A prospective, controlled, randomized, double-blind study of laparoscopic gastric banding included 113 patients and compared traditional dry-cold (n=35) versus dry-heated (n=40), versus humidified-warm gas (n=38). Pain medications were standardized for all groups. Endpoints were recovery room length of stay, pain location, pain intensity, and total pain medications used postoperatively for up to 10 days.

Results: The humidified-warmed group had statistically significant differences from the other 2 groups with improvement in all end points. The dry-heated group had significantly more pain medication use and increased shoulder and chest pain than the other 2 groups had.

Conclusion: Using warm-humidified gas for laparoscopic gastric banding reduces shoulder pain, shortens recovery room length of stay, and decreases pain medication requirements for up to 10 days postoperatively. Dry-heated gas may cause additional complications as is indicated by the increase in pain medication use and pain intensity.

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Related in: MedlinePlus

Humidified-warm vs dry-cold vs dry-warm medication requirements. The humidified-warm group used statistically significantly less pain medication on all days. The dry-cold group had significantly improved outcomes compared with the dry-warm group.
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Figure 1: Humidified-warm vs dry-cold vs dry-warm medication requirements. The humidified-warm group used statistically significantly less pain medication on all days. The dry-cold group had significantly improved outcomes compared with the dry-warm group.

Mentions: Medication requirements for the Insuflow vs. dry-heated and Insuflow vs. dry-cold groups was statistical significantly less, P<0.05 total morphine requirements. The total morphine requirements for the Insuflow group was less than half that for the dry-warm and dry-cold groups (Figures 1). VRS pain score comparisons and statistical evaluations comparing each group showed a statistically significant reduction in pain scores for the Insuflow group (based on VAS scoring). Humidified-warmed Insuflow® produced the lowest pain scores compared to dry-cold and dry-warm and combined (P<0.05). The dry-cold conventional group had pain scores higher than the humidified-warmed P<0.05 and less than the dry-heated group. The dry-heated Stryker group had the highest pain scores compared with dry-cold and humidified-warmed P<0.05.


Improved outcomes for lap-banding using the Insuflow device compared with heated-only gas.

Benavides R, Wong A, Nguyen H - JSLS (2009 Jul-Sep)

Humidified-warm vs dry-cold vs dry-warm medication requirements. The humidified-warm group used statistically significantly less pain medication on all days. The dry-cold group had significantly improved outcomes compared with the dry-warm group.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3015987&req=5

Figure 1: Humidified-warm vs dry-cold vs dry-warm medication requirements. The humidified-warm group used statistically significantly less pain medication on all days. The dry-cold group had significantly improved outcomes compared with the dry-warm group.
Mentions: Medication requirements for the Insuflow vs. dry-heated and Insuflow vs. dry-cold groups was statistical significantly less, P<0.05 total morphine requirements. The total morphine requirements for the Insuflow group was less than half that for the dry-warm and dry-cold groups (Figures 1). VRS pain score comparisons and statistical evaluations comparing each group showed a statistically significant reduction in pain scores for the Insuflow group (based on VAS scoring). Humidified-warmed Insuflow® produced the lowest pain scores compared to dry-cold and dry-warm and combined (P<0.05). The dry-cold conventional group had pain scores higher than the humidified-warmed P<0.05 and less than the dry-heated group. The dry-heated Stryker group had the highest pain scores compared with dry-cold and humidified-warmed P<0.05.

Bottom Line: The humidified-warmed group had statistically significant differences from the other 2 groups with improvement in all end points.The dry-heated group had significantly more pain medication use and increased shoulder and chest pain than the other 2 groups had.Dry-heated gas may cause additional complications as is indicated by the increase in pain medication use and pain intensity.

View Article: PubMed Central - PubMed

Affiliation: Surgery Center of Richardson, Texas, USA. scasey@aigb.com

ABSTRACT

Background and objectives: Preconditioning gas by humidification and warming the pneumoperitoneum improves laparoscopic outcomes. This prevents peritoneal desiccation and detrimental events related to traditional cold-dry gas. Few comparisons have been done comparing traditional cold-dry, heated-only, and humidified-warmed carbon dioxide.

Methods: A prospective, controlled, randomized, double-blind study of laparoscopic gastric banding included 113 patients and compared traditional dry-cold (n=35) versus dry-heated (n=40), versus humidified-warm gas (n=38). Pain medications were standardized for all groups. Endpoints were recovery room length of stay, pain location, pain intensity, and total pain medications used postoperatively for up to 10 days.

Results: The humidified-warmed group had statistically significant differences from the other 2 groups with improvement in all end points. The dry-heated group had significantly more pain medication use and increased shoulder and chest pain than the other 2 groups had.

Conclusion: Using warm-humidified gas for laparoscopic gastric banding reduces shoulder pain, shortens recovery room length of stay, and decreases pain medication requirements for up to 10 days postoperatively. Dry-heated gas may cause additional complications as is indicated by the increase in pain medication use and pain intensity.

Show MeSH
Related in: MedlinePlus