The Effects of Irrigation Fluid on Core Temperature in Endoscopic Urological Surgery

Abstract

There is a drop in temperature in patients undergoing most endoscopic operations on the GU tract and this appears to be multifactorial in origin, relating significantly to weight, amount of irrigation fluid used, type and duration of operation. Warming irrigant fluid to body temperature appears to significantly reduce the degree of temperature drop with consequent potential benefit.

A prospective randomized double-blind study on the effects of the temperature of irrigation solutions on thermoregulation and postoperative complications in percutaneous nephrolithotomy

“…There seems to be a series of factors contributing to decreases in core body temperature in connection with the technique applied in PCNL operations. A study assessing 100 patients undergoing urological endoscopic surgery (29 undergoing transurethral prostate resection, 10 undergoing transurethral bladder tumor resection, 6 undergoing PCLN, and 55 undergoing cystoscopy) found the decrease in core body temperature to be most in PCNL operations [6]. One of the factors that might cause hypothermia in PCNL is the application of warming blankets to a limited area cephalad to the surgical site.…”

“…Administration of excessive amounts of irrigation fluids may contribute to heat loss. Studies of surgical procedures in which irrigation fluids are administered have produced conflicting results regarding whether irrigation fluids increase the risk of hypothermia [4][5][6][7][8][9].…”

“…Percutaneous nephrolithotomy (PCNL) carries a high risk of hypothermia, because of long anesthesia durations, and the characteristics of the surgery [6]. Loss of heat is promoted by factors such as repositioning of the patient after anesthesia induction and difficulties to deploy warmers because of the surgery site.…”

Minimally invasive percutaneous nephrolithotomy: an effective treatment for kidney stones in infants under 1 year of age. A single-center experience

“…PNL carries a high risk of hypothermia because of the duration of anesthesia and the characteristics of the surgery [18]. A series of complications and adverse effects are related to hypothermia, which include cardiac arrhythmias and ischemia, reduced drug metabolism, late emergence and late recovery from anesthesia, mental state changes, impaired renal function, impaired wound healing, elevated infection rates, bleeding disorders, shivering, elevated oxygen consumption, impaired peripheral circulation, hypercarbia, hypoxia, and lactic acidosis [19].…”

A systematic review of randomised controlled trials of the effects of warmed irrigation fluid on core body temperature during endoscopic surgeries

“…2005, p. 10) and we failed to contact the author and (2) four studies (Heathcote & Dyer 1986, Harioka et al. 1988, Mirza et al. 2007, Board & Srinivasan 2008) were non‐randomised controlled trials.…”