Effect of different thermal insulation measures on hypothermia of patients undergoing transurethral resection of prostate under general anesthesia

Objective To further investigate the therapeutic effects of different temperature maintenance strategies on hypothermia in patients undergoing transurethral resection of the prostate (TRUP) under general anesthesia. Methods A total of 120 patients undergoing elective TURP under general anesthesia were randomized into four groups: Group A received traditional treatment without special hypothermia prevention measures; group B received irrigation fluid warming); group C received forced-air blanket warming; and group D received irrigation fluid warming + forced-air blanket warming). The nasopharyngeal temperature, hemodynamic changes and myocardial oxygen consumption of the patients in the four groups were observed and compared at seven time points: entry into the operating room (T1), 10 min after general anesthesia (T2), 10 min after continuous irrigation (T3), 30 min after continuous irrigation (T4), 60 min after continuous irrigation (T5), termination of irrigation (T6), and at the end of anesthesia (T7). Meanwhile, the plasma cytokines before operation and at 3 h after operation, postoperative complications, patient satisfaction, and length of stay were observed and compared. Results Statistically significant differences in nasopharyngeal temperature were observed among the four groups at various time points since T3 (P<0.01). Group D exhibited significantly milder fluctuation of nasopharyngeal temperature than the groups A, B and C (P<0.05). The fluctuations of heart rate (HR), mean arterial pressure (MAP), and myocardial oxygen consumption in group D were milder than the other three groups, showing significant differences (P<0.05). At 3 h postoperatively, the serum levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) dropped significantly in group A, while the serum interleukin-10 (IL-10) level rose significantly, as compared to groups B, C and D (P<0.01). Significantly increased incidences of chills, shivering, nausea, vomiting, muscular soreness, and agitation were observed in groups B, C and D in contrast to group A (P<0.01). The rate of patient satisfaction with treatment were significantly higher in groups B, C and D than in group A (P<0.01). No significant differences were observed among groups B, C and D (P>0.05). Furthermore, the lengths of stay in groups B, C and D were significantly shorter than in group A (P<0.05). Conclusions The combination of irrigating fluid warming and forced-air blanket warming can reduce the incidence of hypothermia, maintain the hemodynamic stability, reduce the discomfort of patients, and reduce postoperative shivering and other complications in patients undergoing TURP under general anesthesia.