1 Department of Urology, Faculty of Medicine, Harran University , Sanliurfa, Turkey .
2 Department of Anesthesiology and Reanimation, Faculty of Medicine, Harran University , Sanliurfa, Turkey .
J Endourol. 2018 Nov;32(11):1050-1053. doi: 10.1089/end.2018.0581.
Percutaneous nephrolithotomy (PCNL) is a widely accepted and frequently performed operation for large kidney stones. However, there is not much information about the effects of irrigation fluid temperature as well as many other factors that affect success and complications during the operation. In this study, we aimed to investigate the surgical and anesthesiological effects of irrigation fluid used in body temperature and room temperature during and after PCNL.
A total of 108 PCNL patients were performed between June 2016 and April 2018. The half of these patients (54) were performed with body temperature (37°C) irrigation fluid, hence known as body temperature group (BTG), and the other half with room temperature (22°C) irrigation fluid, called as room temperature group (RTG). For the study, we recorded the body temperature of the patients during and after the operation, the amount of irrigation fluid used, the size and location of the kidney stones, the duration of the operation, postoperative shivering time during the patient's wake-up period, pre- and postoperative hemoglobin value, additional blood requirements, postoperative analgesic requirements, and postoperative urinary tract infections.
The age of patients, gender distribution, height, weight, body mass index, stone size, and postoperative analgesic requirement showed no significant differences in two groups. The postoperative body heat was significantly higher in the BTG than the RTG. The duration of waking was significantly higher in the RTG than the BTG. The amount of hemorrhage was significantly less in the patients who were irrigated in the RTG.
The temperature of the irrigation fluid can affect many parameters in the PCNL. We recommend using irrigation in room temperature especially with patients having bleeding risks and irrigation fluid in body temperature especially with patients having anesthetic risks for easier waking process.
经皮肾镜碎石术(PCNL)是一种广泛接受且经常实施的治疗大肾结石的手术。然而,关于灌洗液温度以及许多其他影响手术成功率和并发症的因素,我们知之甚少。在这项研究中,我们旨在研究 PCNL 术中及术后使用体温和室温灌洗液对手术和麻醉效果的影响。
共对 2016 年 6 月至 2018 年 4 月期间进行的 108 例 PCNL 患者进行了研究。这些患者中有一半(54 例)使用体温(37°C)灌洗液,称为体温组(BTG),另一半使用室温(22°C)灌洗液,称为室温组(RTG)。为了进行这项研究,我们记录了患者手术期间和手术后的体温、灌洗液用量、肾结石的大小和位置、手术持续时间、患者苏醒期间寒战时间、术前和术后血红蛋白值、额外的血液需求、术后镇痛需求以及术后尿路感染情况。
两组患者的年龄、性别分布、身高、体重、体重指数、结石大小和术后镇痛需求无显著差异。BTG 组患者术后体温明显高于 RTG 组。RTG 组患者苏醒时间明显长于 BTG 组。RTG 组患者出血量明显少于 BTG 组。
灌洗液的温度会影响 PCNL 中的许多参数。我们建议使用室温灌洗液,尤其是在存在出血风险的患者中,以及使用体温灌洗液,尤其是在存在麻醉风险的患者中,以便于患者苏醒。