Effect of different temperature lavage fluid on shivering and inflammatory response after ureteral holmium laser lithotripsy

Feng XIN; Jiuhua LIU; Li FAN

ABSTRACT

Objective:

To investigate the effects of constant body temperature (37 ℃), constant room temperature (24 ℃) and cold liquid (20 ℃) on shivering and inflammatory response after holmium laser lithotripsy under ureteroscope.

Methods:

A total of 132 patients receiving holmium laser lithotripsia under ureteroscope treated in the Second People′s Hospital of Lianyungang City from July 2020 to July 2023 were selected as the study objects. According to the intraoperative lavage fluid temperature, they were divided into cold liquid group (20 ℃, n=44), equal room temperature group (24 ℃, n=44) and equal body temperature group (37 ℃, n=44).. Anova was used to compare the occurrence of postoperative chills in the three groups at 10 min, 30 min, immediately after the operation, and the anti-inflammatory response of stress before and after the operation. Chi-square test was used to compare the occurrence of postoperative chills.

Results:

The difference of core body temperature between the three groups at 10 min, 30 min and immediately after operation was statistically significant. The core body temperature of the cold liquid group was lower than that of the equal room temperature group and the equal body temperature group at the above time point ( P<0.05). There was no significant difference in core body temperature between the isoroom temperature group and the isobody temperature group at 10 min, 30 min and immediately after operation ( P>0.05)..The levels of norepinephrine and serum cortisol in the three groups were higher after surgery than before surgery, and the levels in the cold liquid group were higher than those in the isothermal group and the isothermal group ( P<0.05), but there was no statistical significance between the isothermal group and the isothermal group ( P>0.05).The levels of C-reactive protein, interleukin-10 and white blood cells were higher after operation than before operation, but there was no statistical significance among the three groups ( P>0.05).There was a statistically significant difference in the incidence of postoperative chills among the three groups ( χ2=6.87, P=0.03). Nine cases of postoperative chills occurred in the cold body fluid group, the highest incidence of chills was 20.45%, 3 cases occurred in the room temperature group, and 2 cases occurred in the body temperature group. There was no significant difference in the incidence of chills (6.81% vs 4.55%) ( P>0.05).

Conclusion:

In holmium laser lithotripsy under ureteroscope, compared with cold liquid lavage, intraoperative equi-room temperature lavage and equi-body temperature lavage can maintain constant intraoperative body temperature, relieve stress reaction, reduce postoperative inflammatory reaction and lower incidence of postoperative chills.