Pneumoperitoneum

A condition with trapped gas or air in the PERITONEAL CAVITY, usually secondary to perforation of the internal organs such as the LUNG and the GASTROINTESTINAL TRACT, or to recent surgery. Pneumoperitoneum may be purposely introduced to aid radiological examination.

Networked: 3558 relevant articles (106 outcomes, 430 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Neoplasms (Cancer)
2.	Pain (Aches)
3.	Postoperative Pain
4.	Acidosis
5.	Shoulder Pain

Experts

1.	Kitano, S: 13 articles (08/2005 - 11/2000)
2.	Hwang, Jai-Hyun: 12 articles (03/2022 - 09/2012)
3.	Canis, Michel: 12 articles (12/2017 - 04/2007)
4.	Kim, Young-Kug: 11 articles (03/2022 - 01/2015)
5.	Koninckx, Philippe Robert: 11 articles (03/2011 - 11/2002)
6.	Ishida, H: 11 articles (04/2005 - 02/2000)
7.	Matsuzaki, Sachiko: 10 articles (12/2017 - 04/2007)
8.	Shiraishi, N: 10 articles (08/2005 - 11/2000)
9.	Gutt, C N: 9 articles (12/2006 - 05/2000)
10.	Salihoglu, Ziya: 8 articles (09/2020 - 06/2002)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Pneumoperitoneum:

1.	Carbon DioxideIBA 05/12/2020 - "Clinical Significance: The current recommendations in veterinary laparoscopy for a pneumoperitoneum using carbon dioxide appear to be safe and effective." 09/01/2007 - "The placement of a 2-mm needle port, mandatory to insufflate carbon dioxide and to monitor the pneumoperitoneum, was helpful for further retraction of the gallbladder. " 04/01/1996 - "In pneumoperitoneum, carbon dioxide eliminated in expired gas (carbon dioxide output) contains both metabolic and absorbed carbon dioxide from the peritoneal cavity. " 01/01/2022 - "One trial randomised participants to room air pneumoperitoneum (70 participants) or carbon dioxide pneumoperitoneum (76 participants). " 07/01/2021 - "Our study showed that use of multichannel abdominal port could make laparoscopic instruments easier to fix and operate wherein the vaginal support ring reduces the leakage of carbon dioxide pneumoperitoneum. "
2.	DexmedetomidineFDA Link 01/01/2014 - "This study was intended to investigate the effect of dexmedetomidine on oxidative stress response in pneumoperitoneum established in rats. " 01/01/2023 - "Dexmedetomidine is a potent α_2 agonist which has been used for blunting the stress responses during critical events such as laryngoscopy, endotracheal intubation, pneumoperitoneum creation, and extubation. " 08/01/2019 - "Dexmedetomidine attenuates the increase of ONSD during RALP, suggesting that intraoperative dexmedetomidine administration may effectively attenuate the ICP increase during pneumoperitoneum in the Trendelenburg position." 08/01/2019 - "However, the effects of dexmedetomidine on ICP are controversial and have not been evaluated during RALP under the establishment of pneumoperitoneum in the steep Trendelenburg position. " 07/01/2019 - "Dexmedetomidine significantly attenuated the stress response to laryngoscopy and intubation and pneumoperitoneum and reduced anaesthetic requirement as compared to the other two groups. "
3.	HeliumIBA 05/01/2008 - "Helium ameliorates renal alterations when used for pneumoperitoneum, and it might be used for patients with compromised renal function who have to undergo laparoscopic surgery." 12/01/2006 - "Improved abdominal wall wound healing by helium pneumoperitoneum." 02/01/2008 - "In this study a method for monitoring peritoneal pH during laparoscopy was evaluated and peritoneal pH during CO(2) and helium pneumoperitoneum was studied as well as its systemic reflection in arterial pH. For these experiments 20 pigs were used, with ten exposed to pneumoperitoneum with CO(2), and ten to helium. " 01/01/2005 - "The aim of this study was to investigate the effect of CO2 and helium pneumoperitoneum on the recovery of postoperative gastrointestinal motility. " 09/01/2002 - "For this study, 30 male WAG/Rij rats were randomized into two groups to obtain pneumoperitoneum with CO2 (n=15) or helium (n = 15). "
4.	Anti-Bacterial Agents (Antibiotics)IBA 10/01/2015 - "These findings suggest that clinicians should not neglect a moderate or large pneumoperitoneum, particularly in patients who have an altered mental status or received antibiotics, since peritoneal irritation cannot be observed under these circumstances." 11/01/1955 - "[Surprising results of the institution of a pneumoperitoneum in a tuberculous patient little affected by antibiotics]." 09/01/2016 - "Group 1 patients were all treated with antibiotics; 41% underwent additional interventions: tube readjustments (8%), aspiration of pneumoperitoneum (23%), laparotomy (10%) and intensive care unit admission (10%). " 03/01/2007 - "After two weeks of conservative management, including bowel rest and antibiotics, his pneumoperitoneum resolved spontaneously without any complications. " 09/01/1976 - "Diagnosis of a pneumoperitoneum, prompt operative intervention, and the use of antibiotic therapy are essential to the survival of these infants."
5.	Oxygen (Dioxygen)IBA 01/01/2010 - "Although human studies are lacking, animal data indicate that peritoneal adhesions can be reduced by over 80% with a good surgical technique, with adequate pneumoperitoneum conditioning as adding 3-4% of oxygen to the CO2 pneumoperitoneum, prevention of desiccation and slight cooling. " 11/01/2008 - "A randomized controlled pilot trial to compare the incidence of PSM in women undergoing laparoscopy with a pure CO(2) pneumoperitoneum in comparison with women with CO(2) pneumoperitoneum with the addition of 4% oxygen (Canadian Task Force classification C). " 12/01/2004 - "This study confirms that adhesion formation is decreased with the addition of 3% oxygen to the CO2 pneumoperitoneum. " 10/01/2022 - "A volume controlled ventilation was used with a tidal volume (VT) of 7 mL/kg, an inspired oxygen concentration of 0.60, and an inspiratory to expiratory ratio of 1:2. Left and right myocardial systolic and diastolic function related parameters, including LVEF, LV global longitudinal strain (LVGLS), tricuspid annulus plane systolic migration (TAPSE), the peak early diastolic velocity (E peak) at the mitral and tricuspid valve ostia and the peak early diastolic velocity (e') at the corresponding annulus were measured by transesophageal echocardiography (TEE) before tracheal intubation (T0), 5 minutes after the pneumoperitoneum (T1), 5 minutes after PEEP ventilation (T2), 30 minutes after PEEP ventilation (T3), and 5 minutes after the end of pneumoperitoneum (T4), respectively. " 09/01/2022 - "The partial pressure of oxygen in arterial blood to fractional inspired oxygen (PaO2 /FiO2 ) ratio in the RM + PEEP-EIT arm was higher than that in the PEEP-EIT arm at 1 h after pneumoperitoneum (p = 0.024) and at the end of surgery (p = 0.035). "
6.	Propofol (Diprivan)FDA LinkGeneric 07/01/2020 - "The mean IOP was significantly lower in the propofol-based TIVA group after intubation, pneumoperitoneum, Trendelenburg positioning, and lateral decubitus positioning. " 01/01/2020 - "The predictive performance of propofol TCI during RALP with CO2 pneumoperitoneum in the HDP was acceptable." 01/01/2020 - "The predictive performance of propofol TCI during pneumoperitoneum in the HDP was acceptable (MDPE = - 1.5% and MDAPE = 18.8%). " 01/01/2020 - "We investigated the predictive performance of propofol TCI during CO2 pneumoperitoneum in patients who underwent RALP in the HDP. " 01/01/2006 - "Before and during pneumoperitoneum, there were no significant differences in propofol concentrations between each point. "
7.	salicylhydroxamic acid (SHAM)IBA 10/01/2004 - "Two study groups were subjected to laparoscopic and open bowel injury, and 2 control groups underwent pneumoperitoneum and sham open surgery, respectively, without bowel injury. " 01/01/2002 - "For this study, 50 male Sprague-Dawley rats were divided into five equal groups: control (group 1); sham operation (group 2); 5, 10, or 15 mmHg (group 3, 4, or 5) pneumoperitoneum with CO2 groups. " 01/01/2019 - "70 Wistar rats were used, divided into 7 groups: 1st group sham, 2nd group pneumoperitoneum with 5 mmHg, 3rd group preconditioning with 5 mmHg, 4th group: postconditioning with 5 mmHg, 5th group pneumoperitoneum with 10 mmHg, 6th group: preconditioning with 10 mmHg, 7th group postconditioning with 10 mmHg. " 01/01/2018 - "There was a significant increase in microcirculatory arterioportal shunt flow during the CO2 pneumoperitoneum in both neonatal groups but not in the sham and adolescent groups (p < 0.05). " 02/01/2017 - "Male Sprague-Dawley rats were randomly assigned to one of two experimental groups: sham animals (Sham) and IAP animals who were subjected to a 15 mmHg pressure pneumoperitoneum for 30 minutes. "
8.	Fentanyl (Sublimaze)FDA LinkGeneric 04/01/2015 - "Laparoscopic surgeries have attained the status of a gold standard for most of the abdominal pathology; we therefore performed this study to assess feasibility and safety of major laparoscopic surgeries like laparoscopic cholecystectomy (LC) and laparoscopic assisted vaginal hysterectomy (LAVH)/total laparoscopic hysterectomy (TLH) under regional anesthesia that is combined spinal epidural anesthesia (CSE) with normal pressure pneumoperitoneum using intrathecal fentanyl with bupivacain. " 03/01/2015 - "Heart rate (HR), systolic blood pressure, diastolic blood pressure and mean arterial pressure (MAP) were recorded preoperative, after study drug, after induction, after intubation, after pneumoperitoneum at 15 min intervals, post pneumoperitoneum and postoperative period after 15 min. Propofol induction dose, intraoperative fentanyl requirement and sedation score were also recorded. " 01/01/2022 - "Suppression of hemodynamic response following intubation and pneumoperitoneum by dexmedetomidine nebulization was compared to intravenous dexmedetomidine and fentanyl. " 01/01/2019 - "I.V. fentanyl and I.V. clonidine both were able to attenuate the perioperative hemodynamics response during laryngoscopy and intubation and also during pneumoperitoneum. " 09/01/2016 - "Efficacy of dexmedetomidine and fentanyl on pressor response and pneumoperitoneum in laparoscopic cholecystectomy."
9.	CreatinineIBA 01/01/2016 - "Four studies assessing long-term effects indicated that serum creatinine normalized ≥24 hours after desufflation of pneumoperitoneum at 15mmHg. " 01/01/2016 - "Meta-analysis showed an overall increase in serum creatinine during pneumoperitoneum, and a decrease in urine output and renal blood flow. " 10/01/2008 - "Creatinine levels in blood and urine changed as pressure and pneumoperitoneum duration progressed. " 10/01/2008 - "We investigated the effects of CO(2) induced pneumoperitoneum on kidney function, as reflected by blood and urine creatinine levels, and its relation with renal cell apoptosis. " 02/01/2000 - "In the euvolemic group, prolonged CO2 pneumoperitoneum caused decreased renal blood flow, oliguria, and impaired creatinine clearance. "
10.	Clonidine (ST 155)FDA LinkGeneric 10/01/2017 - "Patients in Group B (Clonidine) maintained greater haemodynamic stability intraoperatively compare to Group A after intubation, during pneumoperitoneum and also extubation. " 10/01/2011 - "Clonidine 2 μg/kg intravenous prevented hemodynamic stress response to pneumoperitoneum and that associated with intubation and extubation (P<0.05). " 10/01/2011 - "Clonidine given 1 μg/kg intravenous attenuated hemodynamic stress response to pneumoperitoneum (P<0.05), but not that associated with intubation and extubation. " 02/01/2003 - "Clonidine preserves heart rate control in pneumoperitoneum and recovery periods. " 02/01/2003 - "Clonidine resulted in a greater perioperative (pneumoperitoneum period) power at all frequency ranges compared with placebo (671.5 +/- 470.5 vs. 55.1 +/- 51.6 ms2/Hz for total power variability, 170.1 +/- 94.4 vs. 16.9 +/- 21.1 ms2/Hz for low-frequency variability and 206.1 +/- 95.7 vs. 16.4 +/- 15.1 ms2/Hz for high-frequency variability, P < 0.05). "

Therapies and Procedures

1.	Laparoscopic Cholecystectomy 08/01/1993 - "This study demonstrated a significant reduction in common femoral venous flow during laparoscopic cholecystectomy coincident with pneumoperitoneum and reverse Trendelenburg's position. " 01/01/2012 - "We think that 10 mmHg pressure pneumoperitoneum is superior to 14 mmHg pressure pneumoperitoneum in laparoscopic cholecystectomy." 01/01/2002 - "Gasless laparoscopic cholecystectomy is a feasible, safe and effective alternative to the pneumoperitoneum technique. " 03/01/2023 - "Background: To study the efficacy of closed and open methods for creating pneumoperitoneum in laparoscopic cholecystectomy by comparing the two in terms of their outcome and complication. " 10/01/2022 - "This systematic review and meta-analysis included 44 randomized controlled trials that compared different pressures of pneumoperitoneum in the setting of elective laparoscopic cholecystectomy. "
2.	Surgical Instruments (Clip) 11/01/2018 - "Surgically, minimally invasive approaches, reducing the laparoscopic trocar size to <10 mm, and evacuating the pneumoperitoneum at the end of the case all have significant benefits. " 04/01/2008 - "This study shows that that when performed by an experienced laparoscopic surgeon the direct trocar insertion technique is a safe and effective alternative for creation of pneumoperitoneum." 06/01/2008 - "Initial laparoscopic access using an optical trocar without pneumoperitoneum is safe and effective in the morbidly obese." 06/01/2008 - "The aim of this study was to examine the safety and efficacy of accessing the peritoneal cavity using an optical, bladeless trocar without previous pneumoperitoneum in morbidly obese patients. " 12/01/2000 - "Efficacy of establishment of pneumoperitoneum with the Veress needle, Hasson trocar, and modified blunt trocar (TrocDoc): a randomized study."
3.	Laparotomy 12/01/2006 - "On POD1 all animals had diminished NKA when compared to controls; NKA after pneumoperitoneum was significantly greater than after laparotomy. " 04/01/2015 - "Though traditionally, anterior approach of the presacral tumours meant laparotomy, but recently, laparoscopy has been reported as a safe and effective option for these tumours with the advantages of a magnified view in the narrow pelvis, easier development of natural planes by pneumoperitoneum, faster recovery and less complications if expertise is available. " 12/01/2021 - "This study assessed the effects of respiratory phase, pneumoperitoneum for laparoscopy, and laparotomy on liver volume in a live porcine model. " 09/01/2020 - "The study aims to evaluate the pneumoperitoneum effect on RBF by comparing renal regional oxygen saturation index (rSrO2) measured by near-infrared spectroscopy (NIRS) in pediatric patients having laparotomy and laparoscopy. " 01/01/2020 - "Imaging studies revealed pneumoperitoneum and the exploratory laparotomy showed perforation of the sigmoid colon as well as a serosal tear of the transverse colon. "
4.	Conservative Treatment 03/01/1977 - "If the diagnosis of perforated hollow viscus can be eliminated with considerable certainty, then conservative management with careful observation and monitoring may avoid unnecessary surgery, so long as other causes of pneumoperitoneum have been ruled out." 12/06/2022 - "Non-surgical pneumoperitoneum (NSP) refers to some pneumoperitoneum that could be relieved without surgery and only by conservative therapy. " 07/01/2011 - "Pneumoperitoneum occurred in two patients during or after the procedure, but both patients improved with conservative management. " 08/01/2023 - "Conservative management of DKA with spontaneous pneumoperitoneum may be considered if the patient's general condition is stable and there are no signs of peritoneal irritation." 01/01/2023 - "Conservative treatment for pneumoperitoneum secondary to gastric perforation may be a reasonable option, especially when the condition of the patient is unstable."
5.	Analgesia 01/30/2019 - " technique versus "standard" technique for releasing the pneumoperitoneumUse of a specific technique of releasing the pneumoperitoneum (pulmonary recruitment manoeuvre, extended assisted ventilation or actively aspirating intra-abdominal gas) reduced the severity of STP at 24 hours (standardised mean difference (SMD) -0.66, 95% confidence interval (CI) -0.82 to -0.50; 5 RCTs; 670 participants; I2 = 0%, low-quality evidence) and reduced analgesia usage (SMD -0.53, 95% CI -0.70 to -0.35; 4 RCTs; 570 participants; I2 = 91%, low-quality evidence). " 01/30/2019 - "There is low to moderate-quality evidence that the following interventions are associated with a reduction in the incidence or severity, or both, of STP, or a reduction in analgesia requirements for women undergoing gynaecological laparoscopy: a specific technique for releasing the pneumoperitoneum; intraperitoneal fluid instillation; an intraperitoneal drain; and local anaesthetic applied to the peritoneal cavity (not subdiaphragmatic).There is low to moderate-quality evidence that subdiaphragmatic intraperitoneal local anaesthetic and warmed and humidified insufflating gas may not make a difference to the incidence or severity of STP.There" 08/01/2015 - "Our hypothesis was that a single-shot caudal block would increase the duration of analgesia and minimize the hemodynamic response to pneumoperitoneum. " 07/01/2009 - "There was no statistically significant change in blood pressure, heart rate, pain at 6 hours, need for additional analgesia or shoulder tip pain with the use of lower pressure pneumoperitoneum. " 01/16/2022 - "Important perioperative safety considerations include thromboprophylaxis; antibiotic prophylaxis; patient allergies; proper positioning of the patient, stack, and monitor(s); patient appropriate pneumoperitoneum; ergonomic port placement; use of lowest possible intra-abdominal pressure; use of additional five-millimetre (mm) ports as needed; safe use of energy devices and laparoscopic staplers; low threshold for a second opinion; backing out if unsafe to proceed; avoiding hand-over in the middle of the procedure; ensuring all planned procedures have been performed; inclusion of laparoscopic retrieval bags and specimens in the operating count; avoiding 10-15 mm ports for placement of drains; appropriate port closures; and use of long-acting local anaesthetic agents for analgesia. "