Effect of Warmed Hysteroscopic Fluid Distention Medium on Postoperative Core Body Temperature: A Randomized Trial [8J

Abstract

INTRODUCTION: The purpose of this research study was to determine whether warming of the distention fluid during operative hysteroscopy will have an effect on perioperative core body temperature, and secondarily to assess postoperative self-rated pain scores. METHODS: Single-blind, 3-arm stratified randomized trial. Total of 96 patients were randomly allocated to 3 groups. Group 1 received normal saline fluid bags at room temperature 22°C (71.6°F), group 2 received fluid bags pulled from a warming cabinet set at 40°C (104°F), and group 3 received continuously warmed fluid at 40°C (104°F). Randomization was stratified by procedure type (myomectomy and non-myomectomy) to ensure 50% of the cases in each group included resections of submucous leiomyoma. RESULTS: There was no statistically significant difference between the 3 arms of the trial in near-core body temperature (P=.29) or in self-rated pain scores (P=.09). However, when compared to all other procedure types, the myomectomy procedures had statistically significant higher fluid deficits in group 1 (P=.01) and group 2 (P=.02), as well as significantly longer operative times in group 1 (P=.05) and group 2 (P=.03). Group 3 demonstrated no statistically significant difference in average fluid deficit between hysteroscopic myomectomy to all other procedure types (P=.16), despite there not being a statistically significant difference in total procedure time between myomectomy procedures and all other surgical procedure types (P=.42). CONCLUSION: Warming of hysteroscopic distention media did not impact near-core body temperature or post-operative pain scores. Use of continuously warmed hysteroscopic fluid in hysteroscopic myomectomy may decrease operative times as well as volume of fluid deficits.