Effect of the Irrigation Fluid Temperature on Core Temperature in Transurethral Resection of Prostate Patients Under Spinal Versus General Anaesthesia
DOI:
https://doi.org/10.17140/RPAOJ-3-117Keywords:
Transurethral prostate resection, Core temperature, Hypothermia, Prewarmed, Irrigation fluidAbstract
Study Design
Prospective, randomized control trial.
Objectives
To evaluate and compare the effect of warm and unwarmed irrigation fluid and anaesthetic technique on core temperature in patients undergoing Transurethral resection of prostate.
Summary of Background Data
Material and Methods: The present study was conducted in 80 patients belonging to age group18-75 yrs of posted for TURP under general anaesthesia or spinal anaesthesia.
Group A: General Anaesthesia with irrigation fluid at room temperature.
Group B: GeneralAnaesthesia with irrigation fluid at 37 °C.
Group C: Spinal Anaesthesia with irrigation fluid at room temperature.
Group D: Spinal Anaesthesia with irrigation fluid at at 37 °C.
Results
Amongst the four Groups, all the subjects showed consistently reduced core temperature which was statistically significant (p<0.05) at all time intervals. Core temperatures were lower in the group receiving unwarmed irrigation fluid compared with the prewarmed irrigation fluid group at the end of surgery. The mean decrease in core temperature at the end of surgery 4.2105 °F in Group A 1.1105 °F. in Group B, 4.2700 °F. in Group C, 1.4250 °F in Group D. The difference in mean core temperature was not statistically significant in Groups receiving unwarmed fluid. Statistically significant difference in mean core temperature was seen in Group B and Group D.
Conclusion
Use of prewarm irrigation fluid resulted in lesser drop in core temperature as compared than that receiving unwarmed irrigation fluid. The drop was relatively least in patients under general anaesthesia.
References
Sessler DI. Mild perioperative hypothermia. N Engl J Med. 1997; 336: 1730-1737. doi: 10.1056/NEJM199706123362407
Vaughan MS, Vaughan RW, Cork RC. Postoperative hypother-mia in adults: Relationship of age, anesthesia, and shivering to re-warming. Anesth Analg. 1981; 60: 746-751.
Rabke HB, jenicek JA, khouri E. Hypothermia associated with transurethral resection of the prostate. J Urol. 1962; 87: 447-449. doi: 10.1016/S0022-5347(17)64979-6
Evans JW, Singer M, Chapple CR, Macartney N, Walke JM, Mil-roy EJ. Haemodynamic evidence for cardiac stress during transure-thral prostatectomy. Br Med J. 1992; 304: 666-671. doi: 10.1136/ bmj.304.6828.666
Hatch PD. Surgical and anaesthetic considerations in transure-thral resection of the prostate. Anaesth Intensive Care. 1987; 15: 203- 211.
Okeke LI. Effect of warm intravenous and irrigating fluids on body temperature during transurethral resection of the prostate gland. BMC Urol. 2007; 7: 15. doi: 10.1186/1471-2490-7-15
Dobson PM, Caldicott LD, Gerrish SP, Cole JR, Channer KS. Changes in haemodynamic variables during transurethral resection of the prostate: Comparison of general and spinal anaesthesia. Br J Anaesth. 1994; 72(3): 267-271.
Board TN, Srinivasan MS. The effect of irrigation fluid tempera-ture on core body temperature in arthroscopic shoulder surgery. Arch Orthop Trauma Surg. 2008; 128: 531-533. doi: 10.1007/s00402- 007-0368-x
Kim YS, Lee JY, Yang SC, Song JH, Koh HS, Park WK. Compar-ative study of the influence of room temperature and warmed flu-id irrigation on body temperature in arthroscopic shoulder surgery. Arthroscopy. 2009; 25(1): 24-29. doi: 10.1016/j.arthro.2008.08.005
Winter M. Effects of irrigation fluid warming on hypothermia during urologic surgery. Urol Nurs. 1994; 14(1): 6-8.
Singh R, Asthana V, Sharma JP, Lal S. Effect of irrigation fluid temperature on core temperature and haemodynamic changes in transurethral resection of prostate under spinal anesthesia. Anesth Essays Res. 2014; 8: 209-215. doi: 10.4103/0259-1162.134508
Carpenter AA. Hypothermia during transurethral resec-tion of prostate. Urology 1984; 23: 122-124. doi: 10.1016/0090- 4295(84)90003-7
NICE (National Institute for Health and Clinical Excellence). Clinical Practice Guideline. The Management of Inadvertent Periopera-tive Hypothermia in Adults. UK: National Collaborating Centre for Nursing and Supportive Care; 2008: 1-567.
Campbell G, Alderson P, Smith AF, Warttig S. Warming of intravenous and irrigation fluids for preventing inadvertent perio-perative hypothermia. Cochrane Database of Systematic Reviews 2015; 4. Art. No.: CD009891. doi: 10.1002/14651858.CD009891. pub2
Taufan Tenggara, Djoko Rahardjo Effect of irrigating fluid temperature on core body temperature during transurethral resec-tion of the prostate. Med J Indones. 2005; 14: 152-156. doi: 10.1016/ S0090-4295(01)00993-1
Dyer PM. Heathcote PS. Reduction of heat loss during trans-urethral resection of the prostate. Anaesth Intensive Care. 1986; 14: 12-16.
Moore SS, Green CR, Wang FL, Pandit SK, Hurd WW. The role of irrigation in the development of hypothermia during lapa-roscopic surgery. Am J Obstet Gynecol. 1997; 176: 598-602. doi: 10.1016/S0002-9378(97)70554-4
Jaffe JS, McCullough TC, Harkaway RC, Ginsberg PC. Effects of irrigation fluid temperature on core body temperature during transurethral resection of the prostate. Urology. 2001; 57: 1078- 1081. doi: 10.1016/S0090-4295(01)00993-1
Hahn RG. Fluid absorption in endoscopic surgery. Br J An-Submit your article to this journal | https://openventio.org/submit-manuscript/ aesth. 2006; 96: 8-20. doi: 10.1093/bja/aei279
Gehring H, Nahm W, Baerwald J, et al. Irrigation fluid absorp-tion during transurethral resection of prostate: Spinal vs Gen-eral anaesthesia. Acta Anaesthesiol Scand. 1999; 43: 458-463. doi: 10.1034/j.1399-6576.1999.430415.x
Frank SM, Shir Y, Raja SN, Fleisher LA, Beattie C. Core hy-pothermia and skin-surface temperature gradients: Epidural vs. general anesthesia and the effects of age. Anesthesiology. 1994; 80: 502-508.
Jenkins J, Fox J, Sharwood-Smith G. Changes in body heat during transvesical prostatectomy: A comparison of general and epidural anesthesia. Anaesthesia. 1983; 38: 748-753. doi: 10.1111/ j.1365-2044.1983.tb12197.x
Leslie K, Sessler DI. Reduction in the shivering threshold is proportional to spinal block height. Anesthesiology. 1996; 84: 1327- 1331.
Frank SM, Shir Y, Raja SN, Fleisher LA, Beattie C. Core hypo-thermia and skin-surface temperature gradients. Epidural versus general anesthesia and the effects of age. Anesthesiology. 1994 Mar;80(3):502-8.
de Freitas Fonseca M, Andrade CM, Jr., de Mello MJ, Crispi CP. Effect of temperature on fluidity of irrigation fluids. Br J An-aesth. 2011; 106: 51-56. doi: 10.1093/bja/aeq303
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