A prospective randomized double-blind study on the effects of the temperature of irrigation solutions on thermoregulation and postoperative complications in percutaneous nephrolithotomy

Purpose This study investigated the effects of irrigation solutions, administered at either 21 or 37 °C in percutaneous nephrolithotomy (PCNL), on hypothermia and related postoperative complications such as late emergence and late recovery from anesthesia, shivering, lactic acidosis, and excess bleeding. Methods Sixty patients who were scheduled for PCNL were enrolled in this prospective randomized double-blind study. Irrigation solutions at room temperature were administered to patients in group R (30 patients), and warmed irrigation solutions were administered to patients in group W (30 patients). The two groups were compared for core and peripheral body temperature, incidence of hypothermia, duration of emergence from anesthesia, duration of recovery from anesthesia, shivering, lactic acidosis, and hemoglobin levels. Results Hypothermia was incident in 19 patients (63.3 %) in group W and in 27 patients (90 %) in group R at the end of surgery. The difference between the initial and the final core body temperature was 0.9 ± 0.6 °C group W and 1.4 ± 0.7 °C in group R ( p = 0.003). The extubation time was 4.4 ± 2.2 min in group W and 5.9 ± 3 min in group R ( p = 0.032). Shivering was detected in seven patients (23.3 %) in group W and in 15 patients (50 %) in group R ( p = 0.032). The recovery duration was 49.8 ± 24.6 min in group W and 67.6 ± 33.9 min in group R ( p = 0.023). Conclusions Administration of irrigation solutions at room temperature in PCNL operations causes the body temperature to decrease significantly, which results in postoperative complications such as late emergence from anesthesia, late recovery from anesthesia, and shivering.