The Effect Of Hypothermia On Postoperative Cognitive Function In Electrotomy Of Prostate

Objective:To explore the effect of hypothermia on postoperative cognitive function and postoperative complications in patients undergoing electrotomy of prostate,so as to provide references for subsequent clinical work.Methods: A total of 100 patients from affiliated hospital of Yan 'an University who underwent electric resection of prostate under combined lumbar and epidural anesthesia from April 2018 to October 2019 were selected as the study subjects.The nasopharyngeal temperature was monitored before,during and at the end of the operation after the patient was admitted to the operating room to observe the changes of nasopharyngeal temperature.Patients were divided into normal body temperature group and hypothermia group according to whether the intraoperative nasopharyngeal temperature was lower than 36 ?.The patient data collection table was designed to record the basic preoperative and intraoperative information of the patient,such as age,height,weight,infusion volume,American society of anesthesiology(ASA)grading,and the amount of lavage.Meanwhile,various postoperative complications such as postoperative chills,fever and length of hospital stay were recorded for each patient,and the incidence of post operative cognitive impairment(POCD)was assessed using the mini-mental state examination(MMSE).Results:(1)The incidence of hypothermia in patients undergoing electroresection of prostate: a total of 100 cases were collected and 10 cases were excluded.Among the 90 patients collected,51(56.6%)had hypothermia,including 50 with mild hypothermia and1 with moderate hypothermia.The incidence of hypothermia with room temperature lavage over 15000 ml was 76.19%,which was higher than that with lavage less than15000 ml was 13.58%,showing a statistical difference(p<0.05).(2)Postoperative cognitive function: there was no significant difference in MMSE scores between the two groups(P>0.05)on the 1st day before surgery.The difference in MMSE scores betweenthe hypothermia group and the normal body temperature group was statistically significant(P<0.05)on the 1st day after surgery and the 4th day after surgery.MMSE scores in the hypothermia group at the moment of post-1 day(T1)and post-4day(T4)were lower than pre-1 day(T0),there was statistically significant difference(P<0.05).In the normal body temperature group,compare to the pre-1day the MMSE score of normal body temperature at post-1d decreased significant difference(p<0.05),while compare to the pre-1day the MMSE score of normal body temperature at post-4d decreased no significant(p>0.05).(3)According to the occurrence criteria of POCD,the incidence of POCD in the hypothermia group on the first day after surgery was higher than that in the normal body temperature group,and the difference was statistically significant(p<0.05).Although the incidence of POCD in the hypothermia group on the fourth day after surgery was higher than that in the normal body temperature group there was no different(p>0.05).(4)The incidence of postoperative chills and fever in hypothermia group was higher than that in normal body temperature group and the difference was statistically significant(p<0.05).Although the postoperative hospitalization time of hypothermia group was longer than that of normal body temperature group,there was no significant difference.(p<0.05).Conclusion:The incidence of perioperative hypothermia was higher in electrotomy resection of prostate,but most patients had mild hypothermia.The incidence of hypothermia was higher in patients with intraoperative lavage fluid volume exceeding15000 ml than the patients with intraoperative lavage fluid volume less 15000 ml.Intraoperative hypothermia increases the incidence of early POCD,fever and chills after operation.but It has no effect on the length of stay.