The effect of different fresh gas flows on body temperature and nausea and vomiting in morbidly obese patients undergoing laparoscopic sleeve gastrectomy

Obesity is a progressive, chronic and life-threatening disease due to its comorbidities. Low-flow anesthesia (LFA) techniques can be preferred due to their positive effect on environmental acclimatization, cost reducing effect, providing intraoperative physiological respiratory conditions and maintaining the body temperature of the patients. In our study, we aimed to show the effects of different fresh gas flow (FGF) applications on body temperatures and postoperative nausea and vomiting (PONV) in morbidly obese patients undergoing laparoscopic sleeve gastrectomy (LSG) surgery. In our prospective, randomized controlled clinical study, the study was completed with a total of 161 patients whose written consents were obtained between 01/10/2022 and 01/05/2023 after ethics committee approval. Age, gender, body mass index (BMI), American Society of Anesthesiologists (ASA) score, comorbidities, intraoperative hemodynamic parameters and body temperatures, postoperative hemodynamic parameters, body temperatures and presence of nausea and vomiting were recorded from the recovery room to the 24th hour. According to the fresh gas flow rate applied during the operation, patients were divided into 3 groups as Group 1 fresh gas flow rate 2 L/min (Normal flow), Group 2 fresh gas flow rate 1 L/min (Low flow) and Group 3 fresh gas flow rate 0.5 L/min (Minimal flow). Body temperatures and the presence of nausea and vomiting were prospectively evaluated by applying different fresh gas flows to the patients. Comparison of intraoperative and postoperative body temperatures between the groups revealed that patients who underwent low and minimal flow anesthesia had higher body temperatures and lower incidence of postoperative nausea and vomiting. The decrease in body temperature encountered in patients receiving general anesthesia can be prevented by low and minimal flow anesthesia techniques. In conclusion, we think that low and minimal flow anesthesia applications may better maintain body temperature and reduce the incidence of postoperative nausea and vomiting in obese patients undergoing LSG surgery, more extensive research is needed to optimize the applied strategies.