I. Research Background

With the continuous advancement of medicine, the concept of "minimally invasive" surgery has deeply penetrated various fields of surgical operations and is gradually being applied in clinical practice. Gynecological laparoscopic surgery is one of the most widely used surgical methods in recent years. It simplifies complex gynecological procedures that traditionally required open abdominal surgery by utilizing a laparoscope and associated equipment. This technique offers advantages such as less trauma, reduced bleeding, decreased postoperative pain, faster recovery, and shorter hospital stays.

To clear intraoperative blood accumulation, exudate, purulent secretions, etc., normal saline is often used clinically for irrigation. Saline irrigation can also reduce the incidence of postoperative complications like abdominal abscesses, fluid accumulation, and incision infections. Particularly for patients undergoing laparoscopic ovarian chocolate cyst removal, the cyst fluid is quite viscous. The cyst may rupture during removal, causing the fluid to adhere to tissues and the intestinal wall. To effectively clear this fluid, large-volume saline irrigation is commonly used to mitigate inflammatory reactions.

However, irrigating patients with large amounts of room-temperature saline can lead to a drop in body temperature, increasing the incidence of shivering and various other complications [1-5]. Therefore, finding the most appropriate temperature for irrigation fluid is extremely important.

II. Study Description

To address this, the present study [2] investigated the effectiveness of using warmed saline for intraoperative abdominal irrigation in reducing the occurrence of hypothermia in patients. This was conducted under conditions where other factors (influencing patient vital sign changes or postoperative recovery) remained consistent. The research results are reported as follows:

1. Study Subjects: This study selected 60 patients undergoing laparoscopic ovarian chocolate cyst removal at a local hospital. All patients had no severe cardiopulmonary diseases and had normal coagulation and thyroid function. The patients were divided into an experimental group and a control group. Room temperature, anesthesia method, surgery duration, and the volume of irrigation fluid used (2000 ml of normal saline) were consistent for both groups.

2. Intervention Methods: All patients underwent surgery in operating rooms maintained at a temperature of 22–24°C and humidity of 40%–60%. Intravenous access was established. After positioning, a thin cotton quilt was placed over the patients' chests and upper limbs.

(1) Experimental Group: Received intraoperative irrigation with normal saline warmed to 36.5°C – 37°C.

(2) Control Group: Received intraoperative irrigation with normal saline without any warming measures.

3. Observed Results: Patients' axillary temperatures were measured and recorded before anesthesia induction and immediately after surgery before leaving the operating room. The temperature changes in the two patient groups are shown in the table below: (Note: The hospital where this study was conducted is Dazhou Central Hospital, Sichuan, China.)

III. Discussion

1. Impact of Hypothermia on Surgical Patients

The results of this study show that the body temperature of patients in the experimental group changed little before and after surgery, while the temperature in the control group decreased significantly. Therefore, during laparoscopic surgery, repeatedly irrigating the abdominal cavity with large amounts of unwarmed normal saline can lead to heat loss and cause a drop in the patient's body temperature.

Hypothermia can cause many adverse effects in patients, such as an increased risk of infection, prolonged hospital stays, higher medical costs, and coagulation disorders [3-4]. Therefore, to ensure the safety of surgical patients and prevent the occurrence of intraoperative hypothermia, using warm saline close to physiological temperature for abdominal irrigation can effectively prevent the loss of body heat and inhibit vasoconstriction [1], thereby avoiding various complications caused by low temperatures and ensuring patient safety.

2. Impact of Shivering on Surgical Patients

The results indicate that the incidence of shivering was significantly higher in the control group, which did not use warmed saline for irrigation during surgery, compared to the experimental group.

Therefore, to prevent shivering, warming intraoperative saline irrigation fluid is an effective heat preservation measure.

IV. Conclusion

In summary, during gynecological laparoscopic surgeries, particularly for patients undergoing ovarian chocolate cyst removal requiring large volumes of irrigation fluid, the intraoperative use of warmed normal saline for irrigation can effectively reduce postoperative temperature decrease, heat loss, and the occurrence of shivering.

More importantly, it helps avoid various complications associated with hypothermia, facilitates postoperative recovery, and improves the quality of operating room nursing care. Moreover, this method is simple and easy to implement, holding significant importance for clinical practice.

References:

1. Wang L. Observation on the effect of abdominal irrigation with irrigation fluids at two different temperatures. Modern Medicine & Health, 2007, 2.3(1).

2. Che QM, Nie J, Li YQ. Effect of warmed irrigation fluid on body temperature in patients undergoing gynecological laparoscopic surgery. Chinese Journal of Maternal and Child Health Research, 2006, Volume 27 (Clinical Diagnosis and Treatment) Issue 1. pp. 198-199.

3. Scott AV, Stonemetz JL, Wasey JO, Johnson DJ, Rivers RJ, Koch CG, Frank SM.Compliance withsurgical care improvement project for body temperature management(SCIP Inf-10) is associated withimproved clinical outcomes. Anesthesiology.

4. Giuliano KK, Hendricks J. Inadvertent perioperative hypothermia: current nursing knowledge.AORNJ.2017;105:453-463.

5. Crossley AW. Six Months of shivering in a district general hospital.Anaesthesia.1992;47:845–848.

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