Effect of irrigating fluid on perioperative temperature regulation during transurethral prostatectomy

Hypothermia in the immediate postoperative period is associated with postoperative instability, prolonged recovery and increased risk of myocardial ischemia in the subsequent 24 h. This study examined the effect of irrigating-fluid temperature during transurethral resection of the prostate on perioperative temperature regulation. A randomized prospective study was conducted on twenty-eight consecutive patients undergoing transurethral resections of the prostate. The control group received room-temperature irrigant. The study group received irrigant warmed through the Abbott level-one fluid warmer or in the Ohio Servocare incubator. Fluid temperatures were 17 degrees C for unwarmed fluid, 37 degrees C for level-one fluid, and 35 degrees C for incubator fluid. The incidence of hypothermia (< or = 36 degrees C) in the immediate postoperative period was 95% in the cold-irrigant group and 38% in the warm-irrigant group (p = 0.001). The decrease from pre- to postoperative temperature was greater with cold (0.95 +/- 0.47 degrees C) than with warm (0.42 +/- 0.64 degrees C) irrigant (p = 0.01). The type of anesthesia (spinal versus general) and method of fluid warming (incubator versus level-one) did not have a significant effect on the perioperative temperature drop. Regression analysis demonstrated that the time of resection, amount of prostate resected, volume of irrigant fluid, and volume of intravenous fluid administered were not independent predictors of intraoperative temperature change.