Intraoperative Patient Warming Instead of Gas on the Management of Postoperative Pain in Laparoscopic Colectomy and Cholecystectomy: A Randomized Controlled Trial

TL;DR

This study shows that warming patients during surgery reduces postoperative pain and analgesic use in laparoscopic procedures.

Contribution

The study introduces intraoperative patient warming as a novel method to manage postoperative pain in laparoscopic colectomy and cholecystectomy.

Findings

Warmed patients had significantly lower early postoperative pain perception.

VAS scores and analgesic use decreased significantly at 12th and 24th hours in warmed groups.

Intraoperative warming led to higher core and skin temperature measurements.

Abstract

Introduction: Blurred lines remain in details of the association between patient warming with postoperative pain and a proper analgesic requirement. Therefore, the present study proposes to observe the effects of intraoperative patient warming and carbon dioxide insufflation duration in laparoscopic colectomy (LCol) and laparoscopic cholecystectomy (LChol) procedures on postoperative pain, analgesic requirements, and hemodynamics.

Methods: The present study involved 80 cases aged 18-80 years with the American Society of Anesthesiologists I-III classification, possessing two initial groups primarily, one for LCol and one for LChol. Subsequently, each was divided into two through randomization for intraoperative warming. Postoperatively, pain perception, per se, was evaluated using the visual analog scale (VAS) score at the 30 minutes, 1st, 6th, 12th, and 24th hours, along with the impact of pain on hemodynamic parameters and side effects such as nausea/vomiting and the dosage of analgesics used.

Results: Groups actively heated with warm air-blowing devices detected significantly higher intraoperative core and skin temperature measurements, and postoperative early pain perception was significantly lower in the warmed ones. Furthermore, a significant decrease in the VAS scores and the analgesic at the 12th and 24th hours compared to the first six hours was recognized between them.

Conclusion: Consequently, herewith, we postulate that so-called patient warming positively affects the VAS scores.

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