Department of Anesthesiology, Fudan University Shanghai Cancer Center, 270 DongAn Road, Shanghai, 200032, China.
Department of Oncology, Shanghai Medical College, Fudan University, 270 DongAn Road, Shanghai, 200032, China.
BMC Anesthesiol. 2023 Jan 23;23(1):31. doi: 10.1186/s12871-023-01991-8.
Perioperative hypothermia and shivering are common and can cause adverse outcomes. The aim of this study was to investigate the incidence of postoperative hypothermia and shivering and their risk factors in patients undergoing malignant tumor surgery.
This retrospective study collected data from patients with American Society of Anesthesiologists physical status (ASA) I or II who underwent scheduled surgery from November 2020 to March 2021 at Fudan University Shanghai Cancer Center. Each patient's core body temperature was measured at three time points: time point 1 (arrival at the postanesthesia care unit (PACU)), time point 2 (after 30-min care in the PACU), and time point 3 (at discharge from the PACU). At time point 1, if the patient's body temperature was below 36 ℃, we provided an active forced-air warmer. At time point 2, if it was still below 36 ℃, the forced-air warmer was still applied until the patient was discharged from the PACU. If it reached 36 ℃, the forced-air warmer would be switched off. Univariate and multivariate logistic regression combined with stepwise methods and linear regression were used to explore risk factors for postoperative hypothermia and shivering.
The numbers (percentage) of 202 patients who developed postoperative hypothermia at the different time points were 52 (25.7%), 37 (18.3%) and 28 (13.9%). Eight patients (4.0%) experienced shivering. Multivariate logistic regression showed that high weight (OR = 0.923, 95% CI: 0.884 to 0.964, P = 0.0003) and low estimated blood loss (OR = 0.252, 95% CI: 0.115 to 0.550, P = 0.0005) were protective factors against hypothermia, while long surgical duration (OR = 3.339, 95% CI: 1.675 to 6.655, P = 0.0006) was an independent risk factor for hypothermia at time point 1. There was no risk factor associated with the occurrence of shivering (P > 0.05). There was a significant difference between the hypothermia and normothermia groups in the median length of stay in the PACU (59.0 vs. 49.0 min, P = 0.0123).
Postoperative hypothermia occurred frequently. Weight, estimated blood loss and surgical duration were significantly associated with hypothermia on arrival at the PACU.
围手术期低体温和寒战较为常见，可导致不良后果。本研究旨在探讨恶性肿瘤手术患者术后低体温和寒战的发生率及其危险因素。
这是一项回顾性研究，纳入了 2020 年 11 月至 2021 年 3 月在复旦大学附属肿瘤医院行择期手术、美国麻醉医师协会（ASA）分级 I 或 II 级的患者。每位患者在三个时间点测量核心体温：时间点 1（到达麻醉后恢复室（PACU）时）、时间点 2（PACU 中 30 分钟护理后）和时间点 3（离开 PACU 时）。如果患者的体温在时间点 1 时低于 36℃，我们会提供主动空气加热设备。如果在时间点 2 时体温仍低于 36℃，仍会继续使用空气加热设备，直到患者离开 PACU。如果体温达到 36℃，则关闭空气加热设备。采用单因素和多因素逻辑回归结合逐步法和线性回归分析，探讨术后低体温和寒战的危险因素。
202 例患者在不同时间点发生术后低体温的例数（百分比）分别为 52 例（25.7%）、37 例（18.3%）和 28 例（13.9%）。8 例（4.0%）患者出现寒战。多因素逻辑回归显示，体重高（OR=0.923，95%CI：0.884 至 0.964，P=0.0003）和估计失血量低（OR=0.252，95%CI：0.115 至 0.550，P=0.0005）是低体温的保护因素，而手术时间长（OR=3.339，95%CI：1.675 至 6.655，P=0.0006）是时间点 1 低体温的独立危险因素。与寒战的发生无相关的危险因素（P＞0.05）。低体温组与正常体温组在 PACU 停留时间中位数上有显著差异（59.0 分钟比 49.0 分钟，P=0.0123）。
术后低体温较为常见。体重、估计失血量和手术时间与 PACU 到达时的低体温显著相关。
