Effect of adding more than 3% oxygen to carbon dioxide pneumoperitoneum on adhesion formation in a laparoscopic mouse model.

Abstract

OBJECTIVE:

To investigate the effect of the addition of 3% or higher oxygen concentrations to the carbon dioxide (CO2) pneumoperitoneum.

DESIGN:

Prospective, randomized trial.

SETTING:

Academic research center.

ANIMAL(S):

Female Naval Medical Research Institute mice (n = 100).

INTERVENTION(S):

Sixty minutes of CO2 pneumoperitoneum with 0%, 3%, 6%, 9%, or 12% oxygen; induction of adhesions by the creation of standardized peritoneal lesions during laparoscopy.

MAIN OUTCOME MEASURE(S):

Adhesions were quantitatively and qualitatively scored after 7 days during laparotomy to determine [1] the effect of 60 minutes of CO2 pneumoperitoneum with 0%, 3%, 6%, 9%, or 12% oxygen on adhesion formation, and [2] the effect of duration of CO2 pneumoperitoneum and insufflation pressure on adhesion formation with the addition of 0%, 3%, and 12% oxygen.

RESULT(S):

Compared with a CO2 pneumoperitoneum with 3% oxygen, adhesion formation is greater when either no oxygen or more than 3% oxygen is added to the CO2 pneumoperitoneum. These effects persisted at higher insufflation pressures and longer duration of pneumoperitoneum, both known to increase adhesion formation with pure CO2.

CONCLUSION(S):

This study confirms that adhesion formation is decreased with the addition of 3% oxygen to the CO2 pneumoperitoneum. The addition of higher oxygen concentrations, however, is deleterious. Adhesions always increase with time and duration of the pneumoperitoneum.

• Authors: Osama Ali Elkelani, Maria Mercedes Binda, Carlos Roger Molinas, Philippe Robert Koninckx
• Journal: Fertility and sterility (Fertil Steril) Vol. 82 Issue 6 Pg. 1616-22 (Dec 2004) ISSN: 0015-0282 [Print] United States
• PMID: 15589868 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Carbon Dioxide
• Oxygen

Topics

• Animals
• Carbon Dioxide
• Dose-Response Relationship, Drug
• Female
• Laparoscopy
• Mice
• Mice, Inbred Strains
• Oxygen (administration & dosage, pharmacology)
• Peritoneal Diseases (etiology, pathology, prevention & control)
• Pneumoperitoneum, Artificial
• Random Allocation
• Time Factors
• Tissue Adhesions (etiology, pathology, prevention & control)