Liu Jingfeng, Huang Xiaohong, Xu Xiaowei, Song Yanyan, Chen Jie, Yu Pei, Ye Tingjun, Zhang Yin, Zhao Dahang, Li Gen, Wang Lei, Wang Ying, Ju Zhenjin, Zhuang Chengyu
Department of Orthopedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Operating Room, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Orthop Surg. 2025 Aug;17(8):2371-2384. doi: 10.1111/os.70123. Epub 2025 Jul 15.
To investigate the effects of warmed irrigation fluid during shoulder arthroscopy on patient temperature regulation, recovery outcomes, and cognitive function.
A randomized single-blind prospective study (Level II) and a total of 85 patients who underwent shoulder arthroscopy at our hospital from February 2022 to April 2023 were selected, all of whom signed informed consent, which was randomly divided into two groups (warmed irrigation fluid group and room temperature fluid group). Among them, there were 29 males (34.1%) and 56 females (65.9%) (male:female ratio = 1:2), with an average age of 60.80 ± 11.70 years (ranging from 19 to 79 years). There were 50 patients (58.8%) aged over 60 and 35 patients (41.2%) aged under 60. All patients were diagnosed with rotator cuff injuries. We recorded primary patient data, anesthesia duration, anesthesia method, surgery duration, intraoperative temperature protection measures, irrigation volume, intraoperative nasopharyngeal and rectal temperatures, and preoperative and postoperative Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores. Statistical analysis was performed to evaluate the impact of warmed irrigation fluid on patient temperature, recovery, and cognitive status.
Analysis of the data from the 85 shoulder arthroscopy patients indicated that warming the irrigation fluid effectively prevented a decrease in core body temperature (nasopharyngeal and rectal temperatures), with significant differences observed at 120 min (nasopharyngeal temperature) and 105 min (rectal temperature). Patients with warmed irrigation fluid had a shorter average anesthesia recovery time than those without warming, although this difference was not statistically significant. Analysis of MMSE and MOCA scores revealed that the areas of cognitive decline post-surgery mainly involved cumulative memory and attention, while orientation was not affected. Education level was identified as a factor influencing cognitive decline.
The administration of warmed irrigation fluid during shoulder arthroscopy has effectively preserved patients' core body temperature. This practice may contribute to a reduction in recovery time and complications associated with the procedure. Furthermore, minimally invasive techniques such as arthroscopy have been associated with a decreased incidence of postoperative cognitive impairment.
探讨肩关节镜检查期间温热冲洗液对患者体温调节、恢复结局及认知功能的影响。
采用随机单盲前瞻性研究（二级研究），选取2022年2月至2023年4月在我院接受肩关节镜检查的85例患者，所有患者均签署知情同意书，将其随机分为两组（温热冲洗液组和室温液体组）。其中男性29例（34.1%），女性56例（65.9%）（男∶女 = 1∶2），平均年龄60.80 ± 11.70岁（19至79岁）。60岁以上患者50例（58.8%），60岁以下患者35例（41.2%）。所有患者均诊断为肩袖损伤。我们记录了患者的基本数据、麻醉时长、麻醉方法、手术时长、术中体温保护措施、冲洗量、术中鼻咽部和直肠温度，以及术前和术后简易精神状态检查表（MMSE）和蒙特利尔认知评估量表（MoCA）评分。进行统计分析以评估温热冲洗液对患者体温、恢复及认知状态的影响。
对85例肩关节镜检查患者的数据分析表明，温热冲洗液可有效防止核心体温（鼻咽部和直肠温度）下降，在120分钟（鼻咽部温度）和105分钟（直肠温度）时观察到显著差异。温热冲洗液组患者的平均麻醉恢复时间比未温热冲洗液组短，尽管这一差异无统计学意义。对MMSE和MoCA评分的分析显示，术后认知功能下降的方面主要涉及累积记忆和注意力，而定向能力未受影响。教育水平被确定为影响认知功能下降的一个因素。
肩关节镜检查期间给予温热冲洗液可有效维持患者的核心体温。这种做法可能有助于减少与该手术相关的恢复时间和并发症。此外，诸如关节镜检查等微创技术与术后认知功能障碍的发生率降低有关。
