Vahit GÜZELBURÇ, MuSTAFA SOYTAŞ, Murat Can KİREMİT, Bülent ERKURT, Bülent ALTAY, Kamil DARÇIN, Ziya AKBULUT, Selami ALBAYRAK

Retrograd İntrarenal Cerrahi Esnasında Oluşan Vücut Sıcaklık Değişikliklerini Etkileyen Faktörler

Amaç: Retrograd intrarenal cerrahi (RIRC) esnasında diğer endoürolojik operasyonlardan farklı olarak daha düşük debi ve hacimde irrigasyon sıvısı kullanılmaktadır. Çalışmamızda kullanılan irrigasyon sıvısına bağlı olarak vücutta oluşan sıcaklık değişiklikleri ve buna etki eden faktörler incelendi. Gereç ve Yöntemler: Prospektif olarak çalışmaya 128 hasta dahil edildi. Operasyonlarda standart olarak 21°C ameliyathane odasında bulundurulan izotonik irrigasyon sıvısı kullanıldı. Hiçbir hastaya aktif ısıtma uygulanmadı. Hastaların ateşi anestezi indüksiyonu öncesinde ve uyandırma öncesinde periferik yoldan ölçüldü. Ölçülen vücut sıcaklık farklarının hasta özellikleri, operasyon süresi, kullanılan irrigasyon sıvısı hacmi ve taş büyüklüğüyle ilişkisi değerlendirildi. Bulgular: Operasyona girişte timpanik ortalama vücut sıcaklığı 36,3±0,35°C iken operasyon sonunda 35,8±0,5°C hesaplandı. Hastaların 102’sinde (%79,7) post-op vücut sıcaklık düşüşü (0,67±0,47°C) kaydedildi. Operasyon öncesi ve sonrasındaki vücut sıcaklık değerleri karşılaştırıldığında anlamlı düşüş saptandı (p<0,0001). Bu düşüş ile hasta ve operatif veriler arasında istatistiksel anlamlı bir ilişki saptanmadı. Sonuç: RIRC sonrasında vücut sıcaklığı düşmektedir ancak ameliyathane oda sıcaklığı dışındaki hasta ve operatif verilerle ateş değişimi arasında ilişki kurulamamıştır.

Anahtar Kelimeler:

İntraoperatif hipotermi, irrigasyon sıvıları, retrograd intrarenal cerrahi, termoregülasyon

The Factors Affecting Body Temperature Changes During Retograde Intrarenal Surgery

Objectives: When compared to other endourologic operations, irrigation fluid with lower flow rate and volume is used during retrograde intrarenal surgery (RIRS). In our study, body temperature changes occurring due to irrigation fluid and factors affecting these were assessed. Materials and Methods: One hundred and twenty-eight patients were prospectively included in the study. During operations, a standart izotonic irrigation fluid kept in the operating room at 21 °C was used. Active heating was not applied to any patient. Body temperature of patients was measured peripherally before anesthesia induction and before recovery. Relationship of body temperature differences with patient characteristics, operation time, irrigation fluid volüme and stone size was evaluated. Results: Mean tympanic body temperature was 36,3±0,35°C at the start of operation and 35,8±0,5°C at the end. Post-operative fall in body temperature (0,67±0,47°C) was recorded in 102 patients (79.7%). When body tempertaure values before and after the operation were compared, a significant reduction was found (p<0,0001). No statistically significant correlation was obtained between this reduction and patient and operative data. Conclusion: Body temperature falls after RIRC however, no relation was found between temperature change and patient and operative data other than operating room temperature.

Keywords:

Intraoperative hypothermia, irrigation solutions, retrograde intrarenal surgery, thermoregulation,

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