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With improvements in equipment and instruments, laparoscopic surgery has become preferred in many diagnostic and therapeutic processes because of its advantages over traditional techniques for many surgical procedures (11), such as ovariectomy (4, 7), ureteronephrectomy, and cystostomy (18, 26). In the process of laparoscopic surgery, CO2 is usually used to offer exposure in the abdominal cavity (15). However, CO2 pneumoperitoneum affects blood gas (9) and liver functions, and causes histological changes in the liver (25). It has also been shown that CO2 pneumoperitoneum-induced liver injury is related to pressure (23). Pneumoperitoneum may result in decreased splanchnic perfusion, affecting hepatic and renal functions (16). It also causes acidosis, organ ischaemic injury (21), oxidative stress, and histological tissue injury (22). To reduce the adverse impact of pneumoperitoneum, researchers have taken a number of measures. For some patients, a low-pressure technique could be used to reduce injury (16), and ischaemic preconditioning could be more useful than the low-pressure technique (3). Hydrogen could be used as an effective antioxidant therapy to protect against oxidative damage (20). Rheumatoid arthritis and related atherosclerosis could be prevented by hydrogen (12). Hydrogen gas reduced oxidative stress in a rat model of traumatic brain injury (14), and experiments showed that 2% H2 inhalation could reduce brain injury in sepsis (17), as well as spinal cord ischemia-reperfusion injury in rabbits (10). To date, however, no controlled studies evaluating the protective effects of hydrogen reducing ischaemic injury on oxidative stress and liver function during pneumoperitoneum in dogs have been reported. In the present clinical study, we aimed to investigate oxidative stress markers and liver function upon insufflation with CO2 under the protective effects of hydrogen. 1) This project was supported with funds provided by the University Nursing Program for Young Scholars with Creative Talents in Heilongjiang Province (UNPYSCT-2016140); “Academic Backbone” Project of Northeast Agricultural University (18XG22). Protective effects of hydrogen on oxidative stress and liver function during CO2 pneumoperitoneum in dogs1)