Effect of warm intravenous and irrigating fluids on body temperature during transurethral resection of the prostate gland

LI Okeke

doi:10.1186/1471-2490-7-15

Abstract

BackgroundTransurethral resection of the prostate gland with irrigation fluid at room temperature leads to perioperative hypothermia which could give rise to adverse cardiovascular events in the perioperative period. The use of isothermic irrigation fluid reduces but does not eliminate this risk. Routine use of warm intravenous fluids along with isothermic irrigation had not been documented. This study set out to investigate the effect of the use of warm intravenous fluid together with isothermic irrigation fluid on the body temperature in patients undergoing transurethral resection of the prostate gland.MethodsOne hundred and twenty consented patients with obstructing benign prostatic hyperplasia were randomly assigned to one of 3 groups. Group 1 received irrigation and intravenous fluids at room temperature, group 2 received warmed irrigation fluid at 38°C along with intravenous fluid at room temperature while group 3 patients received warmed irrigation fluid and warmed intravenous fluids at 38°C. Their perioperative body temperature changes were monitored, analyzed and compared.ResultsThe mean decrease in body temperature at the end of the procedure was significantly greater in group 1 (0.98 ± 0.56°C) than in group 2 (0.42 ± .21°C) (p < 0.001). Significantly more patients in group 1 also experienced shivering. However, in group 3, there was no significant change in the mean body temperature (p > 0.05) and none of them felt cold or shivered.ConclusionIt is concluded that the use of isothermic irrigation fluid together with warm intravenous fluids during TURP prevents the occurrence of perioperative hypothermia.Trial registration numberCCT-NAPN-15944

Highlights

Transurethral resection of the prostate gland with irrigation fluid at room temperature leads to perioperative hypothermia which could give rise to adverse cardiovascular events in the perioperative period
Between January 2001 and December 2005, a total of 120 patients scheduled for transurethral resection of the prostate gland at our institution were enrolled into this randomized study
More of them felt cold and subsequently shivered. These findings are in keeping with those from previous studies where significantly more patients developed perioperative hypothermia following the use of irrigation and intravenous fluids at room temperature during transurethral resection of their prostate gland [2,7,8,10,11]

Summary

Introduction

Transurethral resection of the prostate gland with irrigation fluid at room temperature leads to perioperative hypothermia which could give rise to adverse cardiovascular events in the perioperative period. This study set out to investigate the effect of the use of warm intravenous fluid together with isothermic irrigation fluid on the body temperature in patients undergoing transurethral resection of the prostate gland. Perioperative hypothermia can have a wide range of underappreciated, detrimental effects It increases left ventricular afterload, indicating increased myocardial work and oxygen demand which could result in myocardial ischaemia [3,4]. It induces shivering which has been shown to increase the oxygen consumption by as much as 500% [5].

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Discussion

Conclusion