CO2 Absorption During Laparoscopy
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Purpose
CO2 absorption from the pneumoperitoneum increases over time during laparoscopic procedures. Adding 4% of oxygen to the carbon dioxide was shown in rabbits to decrease CO2 resorbtion through prevention of mesothelial hypoxia. We want to prove this concept in human and expand it to the use of full conditioning.
| Condition | Intervention |
|---|---|
|
Pneumoperitoneum |
Procedure: alteration of the insufflation gas Procedure: full conditioning Procedure: standard pneumoperitoneum |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Single Blind (Subject) Primary Purpose: Prevention |
| Official Title: | Evaluation of Adding 4% of Oxygen and 10% of Nitrous Oxide to the CO2 Pneumoperitoneum Upon CO2 Resorption. |
- CO2 absorption [ Time Frame: measurements for 60 to 240 minutes on average during surgery ] [ Designated as safety issue: Yes ]Measurement of end tidal CO2 during laparoscopic surgery; a decrease would improve safety (less hypercarbia)
- hemodynamic alterations [ Time Frame: measurements for 60 to 240 minutes on average during surgery ] [ Designated as safety issue: Yes ]control of other hemodynamic alterions during laparoscopic surgery.
| Estimated Enrollment: | 60 |
| Study Start Date: | August 2006 |
| Study Completion Date: | September 2011 |
| Primary Completion Date: | September 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: 4% oxygen
addition of 4% oxygen to the CO2 pneumoperitoneum
|
Procedure: alteration of the insufflation gas
addition of 4% oxygen
|
|
Experimental: full conditioning
full conditioning of the peritoneal cavity by the laparoscopic gas: 4% oxygen, 10% nitrous oxide, humidification and set temperature of 32°C
|
Procedure: full conditioning
addition of 4% oxygen + 10% nitrous oxide to the peritoneum
|
|
Active Comparator: CO2 pneumoperitoneum
standard laparoscopy with CO2 pneumoperitoneum
|
Procedure: standard pneumoperitoneum
no intervention besides the use of CO2
|
Detailed Description:
In order to confirm the animal data in the human, a first RCT was performed in which 20 women undergoing a laparoscopy for at least 60 minutes were randomised to a pneumoperitoneum with either 100% carbon dioxide or 96% carbon dioxide plus 4% of oxygen. Insufflation pressure and Trendelenburg were standardised at 15 mm Hg and 30° respectively. In a second trial women were randomized to either 100% carbon dioxide or 86% carbon dioxide plus 4% of oxygen + 10% nitrous oxide + humidification and set temperature of 32°C of the peritoneal cavity.
Eligibility| Genders Eligible for Study: | Female |
| Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
- Women/men planned to undergo a laparoscopic intervention for at least 1 hour and having signed the informed consent
Exclusion Criteria:
- Pregnancy
- Immunodeficiency
- Refuse or unable to sign informed consent
- Chronic disease (i.e. COPD, Crohn, cardiac…)
Contacts and Locations
More Information
No publications provided
| Responsible Party: | Jasper Verguts, MD, University Hospital, Gasthuisberg |
| ClinicalTrials.gov Identifier: | NCT01340989 History of Changes |
| Other Study ID Numbers: | s52645 |
| Study First Received: | April 21, 2011 |
| Last Updated: | October 25, 2011 |
| Health Authority: | Belgium: Institutional Review Board |
Keywords provided by University Hospital, Gasthuisberg:
|
women undergoing laparoscopic surgery for: hysterectomy, colpopexy, endometriosis, adhesions or myomas |
Additional relevant MeSH terms:
|
Pneumoperitoneum Peritoneal Diseases Digestive System Diseases Nitrous Oxide Analgesics, Non-Narcotic Analgesics Sensory System Agents Peripheral Nervous System Agents |
Physiological Effects of Drugs Pharmacologic Actions Central Nervous System Agents Therapeutic Uses Anesthetics, Inhalation Anesthetics, General Anesthetics Central Nervous System Depressants |
ClinicalTrials.gov processed this record on May 23, 2013