Abstract
Pneumoperitoneum using carbon dioxide (CO2) has well-known effects on respiratory system, cardiovascular system, haematological system, pregnancy etc. However, there are no previous published studies regarding the independent effect of CO2 pneumoperitoneum on gastrointestinal dysmotility or post-operative ileus. The purpose of our study was to establish whether prolonged intra-operative CO2 pneumoperitoneum has a correspondingly prolonged post-operative ileus. This experimental study was done using 60 adult guinea pigs, randomly divided into 6 batches of test and control. The test group was subjected to anaesthesia and pneumoperitoneum while the control group was subjected to only anaesthesia for the same duration. Starting with 15 min, each successive batch received an increment of 15 min of pneumoperitoneum and/or anaesthesia time until a maximum of 90 min. The animals were observed post procedure period for time duration of recovery from anaesthesia, ambulation, start of spontaneous feeding and defecation. This study leads us to conclude that the length of CO2 pneumoperitoneum does contribute to post-operative gastrointestinal dysmotility for prolonged procedures, in addition to the central depressant effects of anaesthetics and carbon dioxide.
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References
Yu T, Cheng Y, Wang X, Tu B, Cheng N, Gong J, Bai L, Cochrane Colorectal Cancer Group (2017) Gases for establishing pneumoperitoneum during laparoscopic abdominal surgery. Cochrane Database Syst Rev 6(6):CD009569–CD009569. https://doi.org/10.1002/14651858.CD009569.pub3
de Durães L, C, de Farias IEC, de Morais PHA et al (2013) The effect of carbon dioxide pneumoperitoneum on the healing colonic anastomosis in rats. Acta Cir Bras 28:670–677
Ivatury RR, Diebel L, Porter JM, Simon RJ (1997) Intra-abdominal hypertension and the abdominal compartment syndrome. Surg Clin North Am 77(4):783–800. https://doi.org/10.1016/S0039-6109(05)70584-3
Safran DB, Orlando R III (1994) Physiologic effects of pneumoperitoneum. Am J Surg 167(2):281–286. https://doi.org/10.1016/0002-9610(94)90094-9
Sharma KC, Brandstetter RD, Brensilver JM, Jung LD (1996) Cardiopulmonary physiology and pathophysiology as a consequence of laparoscopic surgery. Chest. 110(3):810–815. https://doi.org/10.1378/chest.110.3.810
Gutt CN, Oniu T, Mehrabi A, Schemmer P, Kashfi A, Kraus T, Büchler MW (2004) Circulatory and respiratory complications of carbon dioxide insufflation. Dig Surg 21(2):95–105. https://doi.org/10.1159/000077038
Bessell JR, Karatassas A, Patterson JR, Jamieson GG, Maddern GJ (1995) Hypothermia induced by laparoscopic insufflation. Surg Endosc 9(7):791–796. https://doi.org/10.1007/BF00190083
Moore FA, Feliciano DV, Andrassy RJ et al (1992) Early enteral feeding, compared with parenteral, reduces postoperative septic complications. The results of a meta-analysis. Ann Surg 216(2):172–183. https://doi.org/10.1097/00000658-199208000-00008
Mattei P, Rombeau JL (2006) Review of the pathophysiology and management of postoperative ileus. World J Surg 30(8):1382–1391. https://doi.org/10.1007/s00268-005-0613-9
Rao D, Kongara D, Snigdha D, Kalyan D (2017) Study of alterations in liver function tests following laparoscopic surgery. IOSR J Dent Med Sci 16:48–54. https://doi.org/10.9790/0853-1603084854
Karabicak I, Kusaslan R, Aydogan F, et al. The effect of hypercarbia on healing of colonic anastomosis during pneumoperitoneum. Med J Bakirköy. January 2010
Waseda M, Murakami M, Kato T, Kusano M (2005) Helium gas pneumoperitoneum can improve the recovery of gastrointestinal motility after a laparoscopic operation. Minim Invasive Ther Allied Technol 14(1):14–18. https://doi.org/10.1080/13645700510010782
CPCSEA Standard operating procedures (SOP) for IAEC, New Delhi, 2010. http://cpcsea.nic.in/WriteReadData/userfiles/file/SOP_CPCSEA_inner_page.pdf
Guidelines for use of laboratory animals in medical colleges, Indian Council of Medical Research, New Delhi, 2001. http://medicaleducationunit.yolasite.com/resources/ICMR-animal use guidelines.pdf. ICMR
Guidelines on anesthesia and analgesia in guinea pigs, Animal care and use program, University of Michigan,2018. https://az.research.umich.edu/animalcare/guidelines/guidelines-anesthesia-and-analgesia-guinea-pigs
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Badarudeen, B., Varghese, B.K., Kumar, M. et al. Effect of Duration of CO2 Pneumoperitoneum on Post Laparoscopic Gastrointestinal Dysmotility: an Experimental Study. Indian J Surg 83, 201–205 (2021). https://doi.org/10.1007/s12262-020-02344-2
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DOI: https://doi.org/10.1007/s12262-020-02344-2