Use of Warmed Irrigation Solution in Arthroscopy: a Systematic Literature Review and a Perspective of Ten Years of Experience in Hip Arthroscopy

Main Article Content

Dante Parodi JoséTomás Bravo Israel González Diego Villegas Carlos Tobar

Abstract

The number of hip arthroscopies has rapidly increased worldwide due to the new knowledge of intraarticular hip pathology. This procedure is successful with a low rate of complications but severe. One of the most important, from the anesthetic point of view, is hypothermia, carrying out a physiological response that could be dangerous for the patients. In hip arthroscopies, a warmed irrigation solution has been implemented as a simple, low-cost, and effective method for preventing hypothermia. There is limited literature on hip arthroscopy; therefore, much of the literature is focused on shoulder and knee arthroscopy.


This systematic review of the literature aims to analyze the current evidence of warmed irrigation solutions in hip, shoulder, and knee arthroscopy.


One reviewer searched the following databases: PubMed, Embase, and Cochrane Library. Level I to level IV studies involving hip, shoulder, or knee arthroscopy were included. The results found in the databases were compared, duplicate records were eliminated, and the rest were reviewed for their inclusion by title and abstract. A full-text review of the manuscripts was performed to ensure that all relevant articles, as well as cross-referenced articles, were included.


Eight studies of patients undergoing arthroscopy were included in the qualitative synthesis (6 shoulder studies, 1 hip study, and 1 knee study; 526 patients). Warm irrigation fluid reduced the degree of core body temperature drop and the incidence of hypothermia in 6 studies (5 shoulder studies and 1 hip study).


In conclusion, warming irrigation fluids for shoulder and hip arthroscopy significantly decreased the risk of hypothermia, increased the lowest mean temperature, decreased the maximum temperature drop, and decreased the risk of shivering and hypothermia.


 

Article Details

How to Cite
PARODI, Dante et al. Use of Warmed Irrigation Solution in Arthroscopy: a Systematic Literature Review and a Perspective of Ten Years of Experience in Hip Arthroscopy. Medical Research Archives, [S.l.], v. 11, n. 3, mar. 2023. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/3129>. Date accessed: 20 apr. 2024. doi: https://doi.org/10.18103/mra.v11i3.3129.
Section
Research Articles

References

1. Zhang J, Pettit M, Sunil Kumar KH, Khanduja V. Recent advances and future trends in hip arthroscopy. J Arthrosc Surg Sport Med. 2020;1(1):81-89. doi:10.25259/jassm_24_2020
2. Imam, S., Khanduja V. Current concepts in the diagnosis and management of femoroacetabular impingement. Int Orthop. 2011;35:1427–1435. doi:https://doi.org/10.1007/s00264-011-1278-7
3. McCarthy JC LJ. Hip arthroscopy: Indications, outcomes, and complications. Instr Course Lect. 2006;55:301-308.
4. Mattu A, Brady WJ PA. Electrocardiographic manifestations of hypothermia. Am J Emerg Med. 2002;20:314-326.
5. Steelman VM, Chae S, Duff J, Anderson MJ, Zaidi A. Warming of Irrigation Fluids for Prevention of Perioperative Hypothermia During Arthroscopy: A Systematic Review and Meta-analysis. Arthrosc - J Arthrosc Relat Surg. 2018;34(3):930-942.e2. doi:10.1016/j.arthro.2017.09.024
6. Parodi D, Tobar C, Valderrama J, et al. Hip arthroscopy and hypothermia. Arthrosc - J Arthrosc Relat Surg. 2012;28(7):924-928. doi:10.1016/j.arthro.2011.12.012
7. Parodi D, Valderrama J, Tobar C, et al. Effect of warmed irrigation solution on core body temperature during hip arthroscopy for femoroacetabular impingement. Arthrosc - J Arthrosc Relat Surg. 2014;30(1):36-41. doi:10.1016/j.arthro.2013.08.035
8. A T. Thermal management during anaesthesia and thermoregulation standards for the prevention of inadvertent perioperative hypothermia. Best Pr Res Clin Anaesthesiol. 2008;22:659-668.
9. DI S. Complications and treatment of mild hypothermia. Anesthesiology. 2001;95:531-543.
10. Insler SR SD. Perioperative thermoregulation and temperature monitoring. Anesth Clin. 2006;24:823-837.
11. Putzu M, Casati A, Berti M, Pagliarini G FG. Clinical complications, monitoring and management of perioperative mild hypothermia: Anesthesiological features. Acta Biomed. 2007;78:163-169.
12. Beilman GJ, Blondet JJ, Nelson TR et al. Early hypothermia in severely injured trauma patients is a significant risk factor for multiple organ dysfunction syndrome but not mortality. Ann Surg. 2009;(249):845-850.
13. Guest JD, Vanni S SL. Mild hypothermia, blood loss and complications in elective spinal surgery. Spine J. 2004;4:130-137.
14. Ercin E, Bilgili MG, Ones HN KC. Postoperative pectoral swelling after shoulder arthroscopy. Joints. 2015;3:158-160.
15. Chellam S, Chiplonkar S PK. Change in neck circumference after shoulder arthroscopy: An observational study. Indian J Anaesth. 2015;59:365-368.
16. Gupta S, Manjuladevi M VUK, Kutappa AM, Amaravathi R AJ. Effects of irrigation fluid in shoulder arthroscopy. Indian J Anaesth. 2016;60:194-198.
17. Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ. 2009;339:b2700.
18. Juni P EM. PRISMAtic reporting of systematic reviews and meta-analyses. Lancet. 2009;374:1221-1223.
19. Kim YS, Lee JY, Yang SC, Song JH, Koh HS, Park WK. Comparative study of the influence of room-temperature and warmed fluid irrigation on body temperature in arthroscopic shoulder surgery. Arthroscopy 2009;25:24-29.
20. Alston SE. Preventing Hypothermia During Shoulder Arthroscopy: Implementing a Pilot Warming Protocol. AORN J. 2020;112(5):524-528. doi:10.1002/aorn.13217
21. Board TN, Srinivasan MS. The effect of irrigation fluid temperature on core body temperature in arthroscopic shoulder surgery. Arch Orthop Trauma Surg 2008;128:531-533.
22. Duff J, Di Staso R, Cobbe KA, et al. Preventing hypothermia in elective arthroscopic shoulder surgery patients: A protocol for a randomised controlled trial. BMC Surg 2012;12:14.
23. Oh JH, Kim JY, Chung SW, et al. Warmed irrigation fluid does not decrease perioperative hypothermia during arthroscopic shoulder surgery. Arthroscopy2014;30:159-164.
24. Pan X, Ye L, Liu Z, Wen H, Hu Y, Xu X. Effect of irrigation fluid temperature on core body temperature and inflammatory response during arthroscopic shoulder surgery. Arch Orthop Trauma Surg 2015;135:1131-1139.
25. Kelly JA, Doughty JK, Hasselbeck AN, Vacchiano CA. The effect of arthroscopic irrigation fluid warming on body temperature. J Perianesth Nurs 2000;15:245-252.
26. Fowler J OB. Abdominal compartment syndrome after hip arthroscopy. Arthroscopy. 2010;26(1):128-130.
27. Sharma A, Sachdev H GM. Abdominal compartment syndrome during hip arthroscopy. Anaesthesia. 2009;64(5):567-569.
28. Verma M SJ. Intrathoracic fluid extravasation after hip arthroscopy. Arthroscopy. 2010;26(9):90-94.
29. Haupt U et al. Intra- and retroperitoneal irrigation liquid after arthroscopy of the hip joint. Arthroscopy. 2008;24(8):966-968.
30. Ladner B, K. Nester and BC. Abdominal fluid extravasation during hip arthroscopy. Arthroscopy. 2010;26(1):131-135.
31. Lin Y, Zhou C, Liu Z, et al. Room Temperature Versus Warm Irrigation Fluid Used for Patients Undergoing Arthroscopic Shoulder Surgery: A Systematic Review and Meta Analysis. J Perianesthesia Nurs. 2020;35(1):48-53. doi:10.1016/j.jopan.2019.06.006
32. Anand Sardesai, Ihab Hujazi VK. Surgical Access Warming Blanket to Prevent Hypothermia After Hip Arthroscopy. Arthroscopy. 2012;28(8):1045-1046.