As a mainstream clinical treatment for benign prostatic hyperplasia, transurethral resection of the prostate (TURP) offers advantages such as less trauma, faster recovery, no abdominal incision, and wide applicability, making it a preferred option for many elderly patients. However, in clinical practice, hypothermia‑induced shivering remains a common problem troubling both patients and medical staff. Shivering not only increases intraoperative discomfort but may also trigger a series of complications, affecting surgical safety and postoperative recovery. Scientific and standardized intraoperative warming measures are the key to solving this problem. A large number of clinical studies have confirmed that targeted warming effectively stabilizes body temperature, greatly reduces the incidence of shivering, and safeguards the surgical process.

Data source for this article: Zhang Hongjie, "Observation on the effect of intraoperative warming on preventing hypothermia‑induced shivering in patients undergoing transurethral resection of the prostate"

I. Research Background

During TURP, a large volume of irrigating fluid is used for bladder washing. Routine room‑temperature irrigating fluid continuously carries away body heat. In addition, elderly patients have reduced thermoregulatory function, making them prone to mild hypothermia (core temperature 34–36°C), which in turn induces hypothermia‑related shivering. Relevant clinical data show that the incidence of shivering in TURP without warming measures can be as high as 63.3%, significantly higher than that in routine surgeries.

To verify the clinical effect of intraoperative warming, a study selected 60 elderly patients undergoing elective TURP. They were randomly divided into a warming group and a control group, with 30 patients in each group. There were no statistically significant differences in general data such as age, body mass, or operation time between the two groups, ensuring scientific rigor and reference value.

(1) Control group protocol: No warming devices were used during surgery. Bladder irrigation was performed with irrigating fluid at room temperature (22–24°C), and the operating room was kept at a conventional temperature.

(2) Warming group protocol: The operating room temperature was optimized to 24–26°C. A forced‑air warming blanket (operating temperature 38–40°C) was applied during surgery. Intravenous fluids were warmed to 39–40°C using a fluid warmer. Bladder irrigation fluid was preheated to a constant 37°C. These measures blocked body heat loss in all aspects.

II. Results

The study results clearly demonstrated the significant advantages of intraoperative warming:

(1) Excellent temperature stability: In the warming group, patients’ core temperature remained stable throughout surgery, with no significant difference between the end of surgery and the preoperative value. In the control group, core temperature at the end of surgery decreased significantly, showing obvious differences compared with both preoperative values and the warming group (P < 0.05).

(2) Greatly reduced shivering incidence: The incidence of shivering was 63.3% in the control group but only 23.3% in the warming group. The difference between the two groups was highly statistically significant (P < 0.01), clearly demonstrating the effectiveness of warming measures.

(3) No increase in intraoperative bleeding risk: The amount of intraoperative blood loss was similar between the two groups, with no statistically significant difference. No major bleeding occurred in either group, confirming that intraoperative warming measures are safe and reliable and do not affect hemostasis.

III. Heartwarming Science Popularization

Intraoperative warming: the invisible shield for elderly patients undergoing surgery

TURP is mainly performed in elderly patients. This population generally has weaker physical function and poorer thermoregulation ability, making them less tolerant to intraoperative hypothermia and more prone to hypothermia‑related complications. The comprehensive warming protocol described in this article is simple to implement and highly safe. Through three measures – raising the operating room temperature, surface warming, and warming all fluids – it reduces body heat loss at the source and precisely maintains a stable core temperature. This not only alleviates the suffering of shivering during surgery but also lowers the risk of various complications induced by hypothermia, providing a solid foundation for a smooth operation and rapid postoperative recovery.

Reference

1. Zhang HJ. Observation on the effect of intraoperative warming on preventing hypothermia‑induced shivering in patients undergoing transurethral resection of the prostate [J]. Journal of Mudanjiang Medical University, 2008, 29(1): 64-65.

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