CARDIOVASCULAR PERFORMANCE AND CORE TEMPERATURE DURING TRANSURETHRAL PROSTATECTOMY

Hemodynamic performance and core temperature were recorded during tran surethral prostatectomy in 52 patients who were stratified according t o cardiac symptom scare and then randomized to undergo standard (31) o r isothermic (21) transurethral prostatectomy. During the standard pro cedure ambient temperature (21C) irrigant was used, while during isoth ermic prostatectomy warmed irrigant at 38C was used to prevent heat lo ss from the bladder, and a warming blanket and humidifying filter were used to decrease cutaneous and respiratory heat loss. Core temperatur e decreased by a mean of 0.8C (95% confidence interval -0.9 to -0.7) d uring standard transurethral prostatectomy and by 0.27C (-0.4 to -0.15 ) during the isothermic procedure. The standard prostatectomy group sh owed a significant hemodynamic response consisting of increased mean a rterial pressure (p < 0.0002), increased index of systemic vascular re sistance (p < 0.0001), bradycardia (p < 0.02), and decreased Doppler i ndexes of stroke volume (p < 0.005) and cardiac output (p < 0.001). Th e isothermic transurethral prostatectomy group was hemodynamically sta ble. These differences between the groups suggest that rapid central c ooling exerted a significant effect on perioperative hemodynamic perfo rmance during transurethral prostatectomy.