A mixture of 86% of CO2, 10% of N2O, and 4% of oxygen permits laparoscopy under local anesthesia: a pilot study

Gynecological Surgery
Philippe Robert KoninckxI Brosens

Abstract

The aim of this study is to verify that 10 % of N2O in CO2 sufficiently reduces pain to permit laparoscopy under local anesthesia. In nine patients undergoing laparoscopy under local anesthesia for tubal sterilization, a mixture of 86 % of CO2, 10 % of N2O, and 4 % of oxygen (the Gas Mixture) was used for the pneumoperitoneum. For CO2, N2O, and for the Gas Mixture, the pain when blowing over the tongue tip and the pH changes of saline and Hartmann's solution were estimated. In all nine patients, discomfort was minimal and the intervention was well tolerated, similar to 100 % N2O. Tongue tip pain (n = 15), on VAS scale, was lower with 86 % CO2 + 10 % N2O + 4 % O2 (2.4 ± 1.4, P = 0.005) and much lower with 100 % N2O (0.3 ± 0.6, P < 0.0007) than with pure CO2 (3.6 ± 1.7). The pH of saline (n = 5) decreased from 7.00 ± 0.07 to 4.18 ± 0.04 (P = 0.001), 6.98 ± 0.08 (NS), and 4.28 ± 0.04 (P = 0.01) with 100 % CO2, 100 % N2O and the Gas Mixture, respectively. The pH of Hartmann's solution (n = 5) decreased similarly from 7.00 ± 0.07 to 5.18 ± 0.04 (P = 0.01), 7.02 ± 0.19 (NS), and 5.3 ± 0.4 (P = 0.01), respectively. These data demonstrate that a mixture with 10 % of N2O and 4 % of O2 in CO2 permits laparoscopy under local anesthesia. T...Continue Reading

References

Jan 1, 1978·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·D E Gunatilake
Sep 27, 1975·British Medical Journal·J S RobinsonA W Wood
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Feb 1, 1996·The Journal of the American Association of Gynecologic Laparoscopists·G H LipscombJ R Spellman
Aug 1, 1997·Human Reproduction·F RisquezE Confino
Apr 18, 1998·The Journal of the American Association of Gynecologic Laparoscopists·N DeQuattroG Davis
Aug 18, 2001·The Journal of the American Association of Gynecologic Laparoscopists·M B TirasF Risquez
Aug 10, 2002·Journal of the American College of Surgeons·Zurab TsereteliJohn G Hunter
Oct 31, 2008·Journal of Minimally Invasive Gynecology·Jasper VergutsPhilippe Koninckx
Feb 8, 2011·Fertility and Sterility·Roberta CoronaPhilippe Robert Koninckx

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Citations

Jun 13, 2019·International Journal of Injury Control and Safety Promotion·Margaret NdagireOlive Kobusingye
Aug 9, 2019·BJOG : an International Journal of Obstetrics and Gynaecology·Jasper VergutsPhilippe Koninckx

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Methods Mentioned

BETA
sedation

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