Habib Zain, Arifuzaman Mohammed, Gupta Apurv, Muscat Neil, Fawzy Sherif I, Rasool Muhammad Umer, Elbeltagi Ahmed, Bilgrami Syed Ali Abbas, Puthan Peedika Muhammed Suneer, Bhattacharya Sayan
Orthopaedics, North Manchester General Hospital, Manchester, GBR.
General Surgery, North Manchester General Hospital, Manchester, GBR.
Cureus. 2024 Sep 25;16(9):e70139. doi: 10.7759/cureus.70139. eCollection 2024 Sep.
Introduction Perioperative hypothermia is a common yet underreported complication of surgery. It results from various factors, including cold operating theaters, anesthetic effects, environmental exposure, exposed tissues, and the administration of cold intravenous or irrigation fluids. This study aims to determine the incidence of perioperative hypothermia in a district National Health Service hospital to assess the feasibility of a randomized controlled trial (RCT) for interventions to prevent hypothermia. Methods This retrospective study included the data of 200 elective surgical patients at North Manchester General Hospital from June 1, 2022, to August 1, 2022. Inclusion criteria were elective general surgery, urology, breast, and gynecology patients aged 18 to 60 years. Exclusion criteria included emergency cases and patients younger than 18 or older than 60. Temperature measurement data were collected from the anesthesia records of the patients at six phases: preoperative, pre-induction, intraoperative, post-procedure, recovery room, and post-recovery. Data collection included specialty, surgery duration, and the use of intraoperative fluid warmers. Statistical analysis was performed using StatsDirect software (StatsDirect Ltd, Wirral, UK). Results Among the 200 patients, the overall incidence of hypothermia was 4% preoperatively, 5% pre-induction, 12% intraoperatively, 11% postoperatively, 8% in recovery, and 6% post-recovery. Intraoperative hypothermia incidence was significant, given that active warming was applied to patients with preoperative hypothermia. Regression analysis showed no correlation between intraoperative temperature and the use of intraoperative fluid warmers. Pre-induction temperature was the most statistically significant predictor of intraoperative hypothermia. Conclusions This study highlights the need for active interventions to recognize and prevent perioperative hypothermia in elective surgical patients. Active pre-warming of patients, regardless of surgery type and duration, is feasible and potentially beneficial. Future research should include an RCT comparing active and passive warming strategies to evaluate their effectiveness in improving perioperative outcomes.
引言 围手术期体温过低是一种常见但报告不足的手术并发症。它由多种因素导致，包括手术室温度过低、麻醉效果、环境暴露、暴露的组织以及输入冷的静脉输液或冲洗液。本研究旨在确定一家地区国民医疗服务体系医院中围手术期体温过低的发生率，以评估进行预防体温过低干预措施的随机对照试验（RCT）的可行性。
方法 这项回顾性研究纳入了2022年6月1日至2022年8月1日在北曼彻斯特综合医院接受择期手术的200例患者的数据。纳入标准为年龄在18至60岁之间的择期普通外科、泌尿外科、乳腺科和妇科患者。排除标准包括急诊病例以及年龄小于18岁或大于60岁的患者。从患者麻醉记录的六个阶段收集体温测量数据：术前、诱导前、术中、术后、恢复室和恢复后。数据收集包括专科、手术时长以及术中液体加温器的使用情况。使用StatsDirect软件（英国威尔拉尔的StatsDirect有限公司）进行统计分析。
结果 在这200例患者中，术前体温过低的总体发生率为4%，诱导前为5%，术中为12%，术后为11%，恢复室为8%，恢复后为6%。鉴于对术前体温过低的患者采用了主动加温措施，术中体温过低的发生率仍较高。回归分析显示术中体温与术中液体加温器的使用之间无相关性。诱导前体温是术中体温过低最具统计学意义的预测因素。
结论 本研究强调了对择期手术患者采取积极干预措施以识别和预防围手术期体温过低的必要性。无论手术类型和时长如何，对患者进行主动预热是可行的且可能有益。未来的研究应包括一项RCT，比较主动和被动加温策略，以评估它们在改善围手术期结局方面的有效性。
