Warmed irrigation fluid does not decrease perioperative hypothermia during arthroscopic shoulder surgery

Joo Han Oh, Joon Yub Kim, Seok Won Chung, Ji Soon Park, Do Hun Kim, Sung Hoon Kim, Mi Ja Yun
Arthroscopy: the Journal of Arthroscopic & related Surgery 2014, 30 (2): 159-64

PURPOSE: To compare the clinical efficacy of warmed irrigation fluid and room-temperature fluid in decreasing perioperative hypothermia during arthroscopic rotator cuff surgery.

METHODS: In this prospective, randomized, comparative study, warmed (36°C) arthroscopic irrigation fluid (group W, n = 36) or room-temperature irrigation fluid (group RT, n = 36) was used without intraoperative warming devices during arthroscopic shoulder surgery in 72 patients. The serial core body temperature and the last and lowest core body temperatures were measured by use of an esophageal stethoscope with a thermometer and a digital tympanic thermometer at 15-minute intervals during the operation and recovery period, respectively. When patients arrived in the postanesthesia care unit (PACU) after surgery, they were warmed immediately and monitored thereafter for body temperature and development of hypothermia-related adverse effects such as postoperative shivering and cardiac events. We evaluated the changes in the patients' weight and prothrombin time on postoperative day 1 and the hemoglobin level and visual analog scale pain score immediately after the operation and on postoperative day 1.

RESULTS: The 2 groups did not differ in demographic and surgical data and incidence of intraoperative hypothermia (33 of 36 [91.6%] in group RT and 34 of 36 [94.4%] in group W, P = .276). The core body temperatures decreased throughout the surgery and increased linearly in the PACU, without any intergroup differences (P > .05). All patients were normothermic within 1 hour of arrival in the PACU. The 2 groups did not differ in postoperative weight change, prothrombin time, hemoglobin level, or postoperative visual analog scale pain score (all P > .05). Postoperative shivering occurred in 3 patients and 1 patient in group RT and group W, respectively. No cardiac events occurred in either group.

CONCLUSIONS: Warmed irrigation fluid was not superior to room-temperature irrigation fluid in reducing the occurrence of perioperative hypothermia during arthroscopic shoulder surgery.

LEVEL OF EVIDENCE: Level I, randomized controlled trial.

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