The Influence of Solution Temperature on Fluid Deficit During Hysteroscopy.

Area of Science:

• Gynecology
• Minimally Invasive Surgery
• Patient Safety

Background:

• Office hysteroscopy utilizes warm distension media to mitigate procedure-related pain.
• Concerns exist that fluid vasodilation may increase intravasation and fluid deficit.
• Limited evidence links irrigation fluid temperature to intravasation risk.

Purpose of the Study:

• To evaluate the association between irrigation fluid temperature and fluid deficit during hysteroscopy.
• To determine if warmer irrigation fluid increases the risk of fluid intravasation.
• To assess the impact of fluid temperature on operative hysteroscopy duration and patient comfort.

Main Methods:

• A randomized controlled trial involving 91 women undergoing operative hysteroscopy.
• Participants were assigned to receive irrigation fluid at either room temperature (24°C) or body temperature (37°C).
• The primary outcome was the time to reach a 250 mL fluid deficit; patient comfort was assessed via visual analog scale (VAS).

Main Results:

• No significant difference was observed in the time to reach a 250 mL fluid deficit between the room temperature and body temperature groups (p=0.25).
• Exploratory analyses at higher fluid deficit thresholds also showed no significant differences.
• A trend towards higher VAS pain scores was reported in the room temperature group compared to the warmed fluid group (p=0.38).

Conclusions:

• Irrigation fluid temperature does not significantly impact fluid deficit during hysteroscopy.
• Warmed irrigation fluid may enhance patient comfort during hysteroscopy without elevating intravasation risks.
• These findings support the use of warmed fluids for improved patient experience in hysteroscopy procedures.