A RANDOMIZED, CONTROLLED TRIAL TO COMPARE HEATED HUMIDIFIED GAS VERSUS HEATED DRY GAS AT LAPAROSCOPY TO REDUCE PAIN AND NARCOTIC USAGE

T. Beste, J. Daucher, D. Holbert

Brody School of Medicine, East Carolina University, Greenville, NC

OBJECTIVE:  To show the use of a humidified heated gas at the time of laparoscopy reduces pain and narcotic usage compared to dry heated gas.

MATERIALS AND METHODS:  A single blinded, randomized, controlled trial of heated humidified gas versus heated dry gas in patients undergoing laparoscopy using random allocation was performed after IRB approval.   Patients were randomly assigned to receive either heated humidified gas or heated dry gas at the time of laparoscopy.  Pain control was achieved per our standard PACU and ambulatory surgery unit protocols.  Verbal analog scales (VAS) were administered at 1, 2, 3, 4, 24 and 48 hours postoperatively to assess pain levels.  The Mann-Whitney U test was performed on the VAS scores.  The Mann-Whitney U test was also used to evaluate the PCA morphine equivalents. 

RESULTS:  41 patients were in the heated humidified gas arm and 36 patients were in the heated dry gas arm for a total of 77 patients.  There was no significant difference between patient demographics.  At 1, 2, 24 and 48 hours, there were lower mean pain scores in the heated humidified gas group (directional p-values of <0.001, 0.024, 0.029 and 0.032 respectively).   There was also a statistically significant decrease in postoperative pain medication usage (directional p-value 0.0465) and decreased total intraoperative and postoperative pain medication usage (directional p-value 0.03) in the study group. 

CONCLUSIONS:  Heated humidified gas at the time of laparoscopy versus heated dry gas is effective in decreasing postoperative pain and narcotics usage.  

Key Words:  humidified gas, postoperative pain, laparoscopy

Disclosure- Nothing to disclose.