Cochrane · systematic review · CD009569
Gases for establishing pneumoperitoneum during laparoscopic abdominal surgery
Yang, X, Cheng, Y, Cheng, N, et al. · Cochrane Database of Systematic Reviews · 2022 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
24
current version
GRADE rated
17
No studies
7
Included studies
NR
No studies 7 · 29.2%Ungraded 0 · 0%Very low 16 · 66.7%Low 1 · 4.2%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyNitrous oxide versus carbon dioxide for establishing pneumoperitoneum during laparoscopic abdominal surgery
Population: people undergoing laparoscopic general abdominal or gynaecological pelvic surgery under general anaesthesia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Cardiopulmonary complications Nitrous oxide vs carbon dioxide | Peto OR 2.62 [0.78, 8.85] | 3 studies · 204 participants | Very low Downgraded: risk of bias, imprecision |
Procedure‐related general complications (surgical morbidity) Nitrous oxide vs carbon dioxide | Peto OR 1.01 [0.14, 7.31] | 3 studies · 207 participants | Very low Downgraded: risk of bias, imprecision |
Pneumoperitoneum‐related serious adverse events Nitrous oxide vs carbon dioxide | no estimate extracted | 4 studies · 260 participants | Very low Downgraded: risk of bias, imprecision |
Mortality Nitrous oxide vs carbon dioxide | no estimate extracted | 4 studies · 260 participants | Very low Downgraded: risk of bias, imprecision |
Quality of life Nitrous oxide vs carbon dioxide | no estimate extracted | NR | No studies |
Pain scores (first postoperative day) VAS, lower score indicates less pain.Scale: 0–10 cm Nitrous oxide vs carbon dioxide | no estimate extracted | 1 study · 64 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Analgesia requirements Nitrous oxide vs carbon dioxide | no estimate extracted | 4 studies · 257 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Costs Nitrous oxide vs carbon dioxide | no estimate extracted | NR | No studies |
Helium versus carbon dioxide for establishing pneumoperitoneum during laparoscopic abdominal surgery
Population: people undergoing laparoscopic general abdominal or gynaecological pelvic surgery under general anaesthesia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Cardiopulmonary complications Helium vs carbon dioxide | Peto OR 1.66 [0.28, 9.72] | 3 studies · 128 participants | Very low Downgraded: risk of bias, imprecision |
Procedure‐related general complications (surgical morbidity) Helium vs carbon dioxide | no estimate extracted | 5 studies · 177 participants | Very low Downgraded: risk of bias, imprecision |
Pneumoperitoneum‐related serious adverse events Helium vs carbon dioxide | Peto OR 8.28 [0.86, 80.03] | 3 studies · 128 participants | Very low Downgraded: risk of bias, imprecision |
Mortality Helium vs carbon dioxide | no estimate extracted | 5 studies · 177 participants | Very low Downgraded: risk of bias, imprecision |
Quality of life Helium vs carbon dioxide | no estimate extracted | NR | No studies |
Pain scores (first postoperative day) Visual analogue scale, lower score indicates less pain.Scale: 0–10 cm Helium vs carbon dioxide | MD 0.49 | 2 studies · 108 participants | Low Downgraded: risk of bias, imprecision |
Analgesia requirements (morphine mg) Helium vs carbon dioxide | MD 12 [4.44, 19.56] | 1 study · 90 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Costs Helium vs carbon dioxide | no estimate extracted | NR | No studies |
Room air versus carbon dioxide for establishing pneumoperitoneum during laparoscopic abdominal surgery
Population: people undergoing laparoscopic general abdominal or gynaecological pelvic surgery under general anaesthesia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Cardiopulmonary complications Room air vs carbon dioxide | no estimate extracted | 1 study · 146 participants | Very low Downgraded: risk of bias, imprecision |
Procedure‐related general complications (surgical morbidity) Room air vs carbon dioxide | no estimate extracted | NR | No studies |
Pneumoperitoneum‐related serious adverse events Room air vs carbon dioxide | no estimate extracted | 1 study · 146 participants | Very low Downgraded: risk of bias, imprecision |
Mortality Room air vs carbon dioxide | no estimate extracted | 1 study · 146 participants | Very low Downgraded: risk of bias, imprecision |
Quality of life Room air vs carbon dioxide | no estimate extracted | NR | No studies |
Pain scores (first postoperative day) Visual analogue scale, lower score indicates less pain.Scale: 0–10 cm Room air vs carbon dioxide | no estimate extracted | 1 study · 146 participants | Very low Downgraded: risk of bias, imprecision |
Analgesia requirements Room air vs carbon dioxide | no estimate extracted | NR | No studies |
Hospital costs (CNY) Room air vs carbon dioxide | no estimate extracted | 1 study · 146 participants | Very low Downgraded: risk of bias, imprecision |
Nitrous oxide versus carbon dioxide for establishing pneumoperitoneum during laparoscopic abdominal surgery
Population: people undergoing laparoscopic general abdominal or gynaecological pelvic surgery under general anaesthesia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Cardiopulmonary complications Nitrous oxide vs carbon dioxide | RR 2 [0.38, 10.43] | 2 studies · 140 participants | Very low Downgraded: risk of bias |
Procedure‐related general complications Nitrous oxide vs carbon dioxide | RR 1.01 [0.18, 5.71] | 2 studies · 143 participants | Very low Downgraded: risk of bias |
Pneumoperitoneum‐related serious adverse events Nitrous oxide vs carbon dioxide | no estimate extracted | 3 studies · 196 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Mortality Nitrous oxide vs carbon dioxide | no estimate extracted | 3 studies · 196 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Quality of life Nitrous oxide vs carbon dioxide | no estimate extracted | NR | No studies |
Pain scores (first postoperative day) VAS, lower score indicates less pain. Scale: 0 cm to 10 cm Nitrous oxide vs carbon dioxide | no estimate extracted | 2 studies · 140 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Analgesia requirements Nitrous oxide vs carbon dioxide | no estimate extracted | 3 studies · 193 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Hospital costs Nitrous oxide vs carbon dioxide | no estimate extracted | NR | No studies |
Helium versus carbon dioxide for establishing pneumoperitoneum during laparoscopic abdominal surgery
Population: people undergoing laparoscopic general abdominal or gynaecological pelvic surgery under general anaesthesia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Cardiopulmonary complications Helium vs carbon dioxide | RR 1.46 [0.35, 6.12] | 3 studies · 128 participants | Very low Downgraded: risk of bias |
Procedure‐related general complications Helium vs carbon dioxide | no estimate extracted | 4 studies · 144 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Pneumoperitoneum‐related serious adverse events Helium vs carbon dioxide | Peto OR 8.28 [0.86, 80.03] | 3 studies · 128 participants | Very low Downgraded: risk of bias |
Mortality Helium vs carbon dioxide | no estimate extracted | 4 studies · 144 participants | Low Downgraded: risk of bias |
Quality of life Helium vs carbon dioxide | no estimate extracted | NR | No studies |
Pain scores (first postoperative day) Visual analogue scale, lower score indicates less pain. Scale: 0 to 10 Helium vs carbon dioxide | MD 0.49 | 2 studies · 108 participants | Very low Downgraded: risk of bias |
Analgesia requirements (morphine mg) Helium vs carbon dioxide | MD 12 [4.44, 19.56] | 1 study · 90 participants | Very low Downgraded: risk of bias |
Hospital costs Helium vs carbon dioxide | no estimate extracted | NR | No studies |
Room air versus carbon dioxide for establishing pneumoperitoneum during laparoscopic abdominal surgery
Population: people undergoing laparoscopic general abdominal or gynaecological pelvic surgery under general anaesthesia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Cardiopulmonary complications Room air vs carbon dioxide | no estimate extracted | 1 study · 146 participants | Very low Downgraded: risk of bias |
Procedure‐related general complications Room air vs carbon dioxide | no estimate extracted | NR | No studies |
Pneumoperitoneum‐related serious adverse events Room air vs carbon dioxide | no estimate extracted | 1 study · 146 participants | Very low Downgraded: risk of bias |
Mortality Room air vs carbon dioxide | no estimate extracted | 1 study · 146 participants | Low Downgraded: risk of bias, imprecision |
Quality of life Room air vs carbon dioxide | no estimate extracted | NR | No studies |
Pain scores (first postoperative day) Visual analogue scale, lower score indicates less pain. Scale: 0 to 10 cm Room air vs carbon dioxide | no estimate extracted | 1 study · 146 participants | Very low Downgraded: risk of bias |
Analgesia requirements Room air vs carbon dioxide | no estimate extracted | NR | No studies |
Hospital costs (CNY) Room air vs carbon dioxide | no estimate extracted | 1 study · 146 participants | Very low Downgraded: risk of bias |
Carbon dioxide versus nitrous oxide for establishing pneumoperitoneum during laparoscopic abdominal surgery
Population: Patients undergoing laparoscopic abdominal surgery
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Cardiopulmonary complications Carbon dioxide vs nitrous oxide | RR 0.5 [0.1, 2.61] | 2 studies · 140 participants | Very low Downgraded: risk of bias, inconsistency, publication bias |
Procedure‐related general complications Carbon dioxide vs nitrous oxide | RR 0.99 [0.18, 5.58] | 2 studies · 143 participants | Very low Downgraded: risk of bias, publication bias |
Pneumoperitoneum‐related serious adverse events Carbon dioxide vs nitrous oxide | no estimate extracted | 3 studies · 196 participants | Very low Downgraded: risk of bias, inconsistency, publication bias |
Pain scores (first post‐operative day) Carbon dioxide vs nitrous oxide | no estimate extracted | 3 studies · 196 participants | Very low Downgraded: risk of bias |
Carbon dioxide versus helium for establishing pneumoperitoneum during laparoscopic abdominal surgery
Population: Patients undergoing laparoscopic abdominal surgery
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Cardiopulmonary complications Carbon dioxide vs helium | RR 0.69 [0.16, 2.88] | 3 studies · 128 participants | Very low Downgraded: risk of bias, publication bias |
Procedure‐related general complications Carbon dioxide vs helium | no estimate extracted | 3 studies · 128 participants | Very low Downgraded: risk of bias, publication bias |
Pneumoperitoneum‐related serious adverse events Carbon dioxide vs helium | RR 0.3 [0.05, 1.83] | 3 studies · 128 participants | Very low Downgraded: risk of bias, publication bias |
Pain scores (first post‐operative day) Carbon dioxide vs helium | no estimate extracted | 2 studies · 108 participants | Very low Downgraded: risk of bias, publication bias |