Effect of different temperature irrigation fluids on patient body temperature in arthroscopic and transurethral resection of prostate surgeries – A systemic review and meta-analysis

• Main Authors: Wen-Yi Lee, 李文怡
• Other Authors: Chien-Yu Chen
• Format: Others
• Language: zh-TW
• Published: 2016
• Online Access: http://ndltd.ncl.edu.tw/handle/7h65yu

碩士 === 臺北醫學大學 === 護理學系碩士暨碩士在職專班 === 104 === Endoscopic surgery that use copious irrigation fluid could lead to the risk of hypothermia. However, effects of using warmed irrigation fluid are still unclear. The objective of this study is to investigate the effects and influences of copious irrigation fluid temperatures on body temperature. Through a systematic literatures search from data base such as Embase, PubMed, and the Cochrane Library, 4 and 8 random control studies were selected respectively from studies related to arthroscopic, and transurethral resection of prostate procedure, and then used for two separate meta analyses, using statistical software, Review Manager 5.3. The results indicated that, in comparison with cold irrigation fluid, the use of warm fluid on arthroscopic surgery did not show significant difference on the decreased hemoglobin level, operation time, and amount of irrigation fluid required. However, using warm irrigation fluid reduced relative risk of shivering by 80% (RR=0.2, 95% CI:0.09-0.45, p<.0001), and hypothermia by 74 % (RR=0.26. 95% CI:0.16-0.41, p=<.0001); average body temperatures were higher by 0.27±0.24℃ (p=0.03) and 0.46±0.38℃ (p=0.02), respectively, 60 and 90 minutes after surgery. But, the VAS pain index score 6 hours after surgery was 0.63±0.5 higher than the group using cold irrigation fluid. For patients who were subjected to the TURP procedures, the use of warm irrigation fluid did not affect surgery time, volume of irrigation fluid used, and amount of prostate tissue removed; but body temperature after the surgery was higher than the use of cold irrigation fluid by 0.64℃± 0.32 (p=.0001), and risk of shivery decreased by 79% (RR=0.21, 95% CI: 0.11-0.40, p=.0001). This study is the first meta-analysis, using data from arthroscopic and TURP surgery irrigated with large amount of warm fluid. It demonstrated that using warm irrigation fluid is an effective method to better maintain body temperature. However, due to the limitation of available studies, both in quality and in quantity, there is insufficient evidence to clearly establish a useful clinical guidance. It is desirable to establish a multi-center research with well controlled random studies to affirm the clinical usefulness of warm irrigation fluid. Furthermore, more information is needed to understand its effects on the pain of surgical wound and its related complications.