The effect of heating insufflation gas on acid-base alterations and core temperature during laparoscopic major abdominal surgery / 대한마취과학회지

BACKGROUND: Carbon dioxide (CO2) has different biophysical properties under different thermal conditions, which may affect its rate of absorption in the blood and the related adverse events. The present study was aimed to investigate the effects of heating of CO2 on acid-base balance using Stewart's physiochemical approach, and body temperature during laparoscopy. METHODS: Thirty adult patients undergoing laparoscopic major abdominal surgery were randomized to receive either room temperature CO2 (control group, n = 15) or heated CO2 (heated group, n = 15). The acid-base parameters were measured 10 min after the induction of anesthesia (T1), 40 min after pneumoperitoneum (T2), at the end of surgery (T3) and 1 h after surgery (T4). Body temperature was measured at 15-min intervals until the end of the surgery. RESULTS: There were no significant differences in pH, PaCO2, the apparent strong ion difference, the strong ion gap, bicarbonate ion, or lactate between two groups throughout the whole investigation period. At T2, pH was decreased whereas PaCO2 was increased in both groups compared with T1 but these changes were not significantly different. Body temperatures in the heated group were significantly higher than those in the control group from 30 to 90 min after pneumoperitoneum. CONCLUSIONS: The heating of insufflating CO2 did not affect changes in the acid-base status and PaCO2 in patients undergoing laparoscopic abdominal surgery when the ventilator was set to maintain constant end-tidal CO2. However, the heated CO2 reduced the decrease in the core body temperature 30 min after the pneumoperitoneum.

Participation of KATP Channels in the Antinociceptive Effect of Pregabalin in Rat Formalin Test

BACKGROUND: Pregabalin is an anticonvulsant and analgesic agent that interacts selectively with the voltage-sensitive-Ca(2+)-channel alpha-2-delta subunit. The aim of this study was to evaluate whether the analgesic action of intrathecal (IT) pregabalin is associated with KATP channels in the rat formalin test. METHODS: IT PE-10 catheters were implanted in male Sprague-Dawley rats (250-300 g) under inhalation anesthesia using enflurane. Nociceptive behavior was defined as the number of hind paw flinches during 60 min after formalin injection. Ten min before formalin injection, IT drug treatments were divided into 3 groups: normal saline (NS) 20 microl (CON group); pregabalin 0.3, 1, 3 and 10 microg in NS 10 microl (PGB group); glibenclamide 100 microg in DMSO 5 microl with pregabalin 0.3, 1, 3 and 10 microg in NS 5 microl (GBC group). All the drugs were flushed with NS 10 microl. Immunohistochemistry for the KATP channel was done with a different set of rats divided into naive, NS and PGB groups. RESULTS: IT pregabalin dose-dependently decreased the flinching number only in phase 2 of formalin test. The log dose response curve of the GBC group shifted to the right with respect to that of the PGB group. Immunohistochemistry for the KATP channel expression on the spinal cord dorsal horn showed no difference among the groups 1 hr after the formalin test. CONCLUSIONS: The antinociceptive effect of pregabalin in the rat formalin test was associated with the activation of the KATP channel. However, pregabalin did not induce KATP channel expression in the spinal cord dorsal horn.