THE ROLE OF IRRIGATION IN THE DEVELOPMENT OF HYPOTHERMIA DURING LAPAROSCOPIC SURGERY

OBJECTIVES: Our purpose was to determine the incidence and etiology of hypothermia during laparoscopic surgery and to evaluate the role of i rrigation fluid temperature. STUDY DESIGN: A prospective randomized st udy was performed of 35 women undergoing operative laparoscopy under g eneral anesthesia who received surgical irrigation fluid either at amb ient temperature or warmed to 39 degrees C. The core body temperature was determined with use of both an esophageal sensor and a tympanic me mbrane sensor and was expressed as the change from baseline. Additiona l data collected included age, height, weight, amount of irrigation fl uid and intravenous fluid used, room temperature, length of anesthesia , and amount of carbon dioxide used for pneumoperitoneum. RESULTS: Hyp othermia occurred in 94% of all patients, with no difference in incide nce between the groups. The minimal core temperature was lower in the ambient temperature group (-1.7 degrees +/- 0.2 degrees C) than in the warmed fluid group (-1.0 degrees +/- 0.2 degrees C). Of the variables measured, length of anesthesia and the amount of ambient temperature fluid alone explained the drop in core temperature. CONCLUSION: Hypoth ermia is extremely common in laparoscopic surgery and is related to th e length of anesthesia and the use of ambient temperature irrigation f luid. The use of warmed irrigation fluid can decrease, but not elimina te, this drop in core temperature.