ISOTHERMAL IRRIGATION DURING TRANSURETHRAL RESECTION OF THE PROSTATE - EFFECTS ON PERIOPERATIVE HYPOTHERMIA, BLOOD-LOSS, RESECTION TIME ANDPATIENT SATISFACTION

Objectives To investigate the effect using irrigation fluid at body te mperature (isothermic) on patients' (core) temperature during a transu rethral resection of the prostate (TURF) and on the amount of peri-ope rative blood loss, the resection time and the subjective assessment of comfort by the patients. Patient and methods in a randomized study, p atients undergoing TURF under spinal anaesthesia were divided into tho se receiving either isothermic irrigation fluid (Group 1, 28 patients) or fluid at room temperature (Group 2, 31 patients), In Group 1, a fl uid heater maintained the irrigation fluid at body temperature until i t reached the bladder. The body temperature of the patients was record ed rectally and orally during and after TURF and the peri-operative bl ood loss was also measured. The patients were interviewed on the first day after TURF to determine their assessment of comfort during the pr ocedure. Results The decrease in body temperature was 0.74 degrees C i n Group 1 and 1.71 degrees C in Group 2, which was significantly diffe rent (P<0.001), There was no significant difference in blood loss or r esection-time, In Group 1, only four (14%) of the patients were aware that their body was cooler, compared to 15 (50%) in Group 2 (P=0.038). Conclusion Isothermic irrigation during TURF prevents excessive cooli ng and reduces the level of hypothermia. The reported increased mortal ity after TURF is probably related to peri-operative cardiac stress, a n important factor which could be caused by the rapid decrease in body temperature which accompanies normal irrigation. Because the heating equipment presently available does not interfere with TURF, there are strong arguments for performing every TURF with irrigation fluid at bo dy temperature.