Effects of Heated-Humidified Anesthetic Gas in the Elderly Patients with Colorectal Cancer during Laparoscopic Surgery: Randomized Controlled Trial

Hyo-Sun Park; Younhee Kang

doi:10.7475/kjan.2018.30.2.206

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Park and Kang: Effects of Heated-Humidified Anesthetic Gas in the Elderly Patients with Colorectal Cancer during Laparoscopic Surgery: Randomized Controlled Trial

Original Article

Korean J Adult Nurs 2018;30(2):206-215.

Published online: 21 April 2018

DOI: https://doi.org/10.7475/kjan.2018.30.2.206

Effects of Heated-Humidified Anesthetic Gas in the Elderly Patients with Colorectal Cancer during Laparoscopic Surgery: Randomized Controlled Trial

Hyo-Sun Park¹, Younhee Kang^2,

¹Gachon University, Gil Hospital, Incheon, Korea

²College of Nursing, Ewha Womans University, Seoul, Korea

Corresponding author: Kang, Younhee https://orcid.org/0000-0002-7964-5674 College of Nursing, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Korea. Tel: +82-2-3277-4483, Fax: +82-2-3277-2850, E-mail: yxk12@ewha.ac.kr

Received 1 January 20182 April 2018 Accepted 12 April 2018

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study aimed to evaluate effects of heated-humidified anesthetic gas on body temperature, acid-base balance, blood cortisol, and lymphocyte in the elderly patients with colorectal cancer during laparoscopic surgery.

Methods

This study utilized an experimental design with a randomized controlled trial. A total of 60 patients with colorectal cancer were randomly assigned to one of two groups: either to the heated-humidified anesthetic gas group or to the usual anesthetic gas group. The following variables were measured: body temperature, acid-base balance, blood cortisol, and lymphocyte. The data were analyzed with independent t-test, x² test, ANCOVA, and repeated ANOVA using SPSS/WIN 20.0.

Results

There was a significant difference in body temperature between the experimental group and the control group during laparoscopic surgery (F=41.18, p<.001). However, no statistically significant differences were found in acid-base balance, blood cortisol, and lymphocyte between two groups.

Conclusion

In this study, the body temperature during laparoscopic surgery was more effectively maintained with the heated-humidified anesthetic gas compared with the regular anesthetic gas. Therefore, the heated-humidified anesthetic gas might be considered to maintain the body temperature during laparoscopic surgery especially in the elderly population.

Keywords: Anesthesia, Colorectal neoplasms, Laparoscopy, Body temperature

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Figure 1.

Differences in body temperature between experimental group and control group.

Table 1.

Homogeneity of General Characteristic between Experimental Group and Control Group (N=60)

Variables	Categories	Exp. (n=30)	Cont. (n=30)	x²	t	p
Variables	Categories	n (%) or M± SD	n (%) or M± SD	x²	t	p
Age (year)		73.7±6.2	72.6±4.2		0.85	.399
Gender	Male	17 (54.8)	13 (44.8)	0.60		.606
Gender	Female	14 (45.2)	16 (55.2)
Diagnosis	Rectal cancer	15 (50.0)	15 (50.0)	0.00		1.000
Diagnosis	Colon cancer	15 (50.0)	15 (50.0)
Operation	Laparoscopic LAR	27 (52.9)	24 (47.1)	1.18		.472
Operation	Laparoscopic colectomy	3 (33.3)	6 (66.7)
Fluid (mL)		1,774±641	1,550±299		1.74	.088
Room temperature (℃)		23.8±1.7	23.6±2.0		0.47	.640
Humidity (%)		26.3±9.1	27.6±9.2		2.76	.594
Anesthetic time (min)		245.3±45.0	226.6±22.2		2.04	.001
Operating time (min)		210.3±38.8	190.5±18.1		2.53	.001
Body temperature (℃)		36.1±0.4	36.0±0.4		1.76	.085
pH		7.45±0.2	7.46±0.3		-0.60	.551
PCO₂ (mmHg)		38.5±4.2	37.6±3.2		0.98	.331
HCO₃^- (mEq/L)		26.8±2.6	26.2±2.5		0.84	.407
Base excess (mEq/L)		2.8±2.5	2.5±2.4		0.45	.655
Cortisol (ug/dL)		15.5±11.9	16.2±9.4		-0.24	.813
Lymphocyte (%)		26.8±9.4	30.7±1.1		-1.50	.140

LAR=low anterior resection; Exp.=experimental group; Cont.=control group.

Table 2.

Differences in Acid Base Balance between Experimental Group and Control Group (N=60)

Variables	Categories	Exp. (n=30)	Cont. (n=30)	Source	F	p
Variables	Categories	M± SD	M± SD	Source	F	p
pH	1	7.45±0.2	7.46±0.3	Group	0.14	.706
	2	7.39±0.1	7.43±0.1	Time	2.35	.066
	3	7.37±0.1	7.38±0.1	G＊ T	2.20	.082
	4	7.38±0.1	7.39±0.1
	5	7.39±0.1	7.36±0.1
PCO2 (mmHg)	1	38.5±4.2	37.6±3.2	Group	4.26	.044
	2	43.3±6.5	38.6±6.9	Time	1.13	.354
	3	44.2±7.5	42.2±5.7	G＊ T	1.87	.129
	4	42.8±8.1	40.3±5.8
	5	39.7±4.9	39.3±4.4
HCO3^- (mEq/L)	1	26.8±2.6	26.2±2.5	Group	0.99	.325
	2	26.0±2.5	25.6±2.3	Time	0.21	.316
	3	25.2±2.4	25.0±2.4	G＊ T	0.77	.552
	4	25.0±2.4	24.7±2.5
	5	24.0±2.3	24.3±2.8
Base excess (mEq/L)	1	2.8±2.5	2.5±2.4	Group	1.05	.309
	2	0.8±2.7	1.0±2.5	Time	0.41	.798
	3	0.0±2.9	-0.3±2.7	G＊ T	4.04	.006
	4	0.0±2.9	0.3±2.7
	5	0.3±2.5	0.6±2.9

Exp.=experimental group; Cont.=control group; G∗T=Group∗Time; 1=Pre-operation; 2=1 hour after surgery; 3=2 hours after surgery; 4=3 hours after surgery; 5=4 hours after surgery.

Table 3.

Differences in Cortisol and Lymphocyte between Experimental Group and Control Group (N=60)

Variables	Categories	Exp. (n=30)	Cont. (n=30)	Source	F	p
Variables	Categories	M± SD	M± SD	Source	F	p
Cortisol	1	15.2±11.9	16.2±9.4	Group	2.35	.131
	2	19.9±8.5	23.2±9.1	Time	4.65	.003
	3	11.2±8.5	10.8±7.5	G＊ T	0.79	.535
	4	13.7±6.7	13.3±4.9
	5	13.0±5.6	12.9±6.3
Lymphocyte	1	26.8±9.4	30.7±1.0	Group	0.60	.442
	2	11.0±8.0	10.3±6.6	Time	1.99	.110
	3	13.3±5.1	14.0±6.2	G＊ T	0.75	.562
	4	17.6±6.3	17.2±5.7
	5	21.1±7.3	22.6±8.1

Exp.=experimental group; Cont.=control group; G∗T=Group∗Time; 1=Pre-operation; 2=1 hour after surgery; 3=1 day after surgery; 4=3 days after surgery; 5=4 days after surgery.

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