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Related Experiment Videos

Cardiovascular performance and core temperature during transurethral prostatectomy

J W Evans1, M Singer, S W Coppinger

  • 1Department of Urology, Middlesex Hospital, London, England.

The Journal of Urology
|December 1, 1994
PubMed
Summary

Maintaining core body temperature during transurethral prostatectomy is crucial. Isothermic procedures, using warmed irrigant, significantly improved hemodynamic stability compared to standard methods.

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Area of Science:

  • Urology
  • Anesthesiology
  • Cardiovascular Physiology

Background:

  • Transurethral prostatectomy (TURP) can lead to significant core body temperature decrease.
  • Hypothermia during surgery can negatively impact hemodynamic stability.
  • Patient cardiac status may influence tolerance to temperature changes during procedures.

Purpose of the Study:

  • To compare the effects of standard versus isothermic transurethral prostatectomy on patient core temperature.
  • To evaluate the impact of these temperature management strategies on perioperative hemodynamic performance.
  • To determine if isothermic TURP improves hemodynamic stability in patients undergoing the procedure.

Main Methods:

  • 52 patients undergoing transurethral prostatectomy were stratified by cardiac symptom score.

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  • Patients were randomized to either standard (21°C irrigant) or isothermic (38°C irrigant, warming blanket, humidifying filter) procedures.
  • Hemodynamic parameters (mean arterial pressure, systemic vascular resistance, heart rate, stroke volume, cardiac output) and core temperature were monitored.

    • Main Results:

    • Standard TURP resulted in a mean core temperature decrease of 0.8°C, while isothermic TURP showed a decrease of only 0.27°C.
    • The standard group exhibited significant hemodynamic changes: increased mean arterial pressure and systemic vascular resistance, bradycardia, and decreased stroke volume and cardiac output.
    • The isothermic TURP group maintained hemodynamic stability throughout the procedure.

    Conclusions:

    • Rapid central cooling during standard transurethral prostatectomy significantly affects perioperative hemodynamic performance.
    • Isothermic transurethral prostatectomy effectively prevents significant core temperature drop and maintains hemodynamic stability.
    • Warming interventions are essential for optimizing patient outcomes during transurethral prostatectomy.