Penjore Tashi, Oofuvong Maliwan, Chatmongkolchart Sunisa, Kitisiripant Chanatthee, Rueangchira-Urai Rongrung, Leeratiwong Jaranya
Department of Anesthesiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand.
PLoS One. 2025 Jan 30;20(1):e0314968. doi: 10.1371/journal.pone.0314968. eCollection 2025.
This study aims to explore the association between intraoperative hypothermia and outcomes in adult patients undergoing laparoscopic surgery.
A retrospective analysis of 2048 adult laparoscopic surgery patients treated between 2020 and 2021 was conducted at Songklanagarind Hospital, Thailand. Intraoperative hypothermia, defined as a core temperature below 36°C, was recorded as either one or more than one episode. Patient demographics, clinical information and postoperative outcomes were extracted from the hospital information system. The outcomes were intraoperative and postoperative cardiac arrhythmias, postoperative oxygen requirement, length of post-anesthetic care unit (PACU) stay, and length of hospital stay. Univariate and multivariate logistic/linear regression models were fit to assess the association between hypothermia and outcomes, presented as odds ratio (OR) or beta-coefficient (β) with 95% confidence interval (CI).
The incidence of intraoperative hypothermia was 34.9%, with 688 experiencing one episode and 27 experiencing multiple episodes. On multivariate analysis, patients with one and more than one episode of hypothermia had an increased risk of intraoperative cardiac arrhythmia compared to normothermic patients (OR [95%CI]: 1.67[1.24,2.25] and 3.65[1.53,8.74], respectively, P<0.001). Normothermic patients and hypothermic patients with more than one-episode had a higher odds of postoperative oxygen requirement compared to hypothermic patients with only one episode (OR [95%CI]:1.32[1.02,1.7] and 2.64[1.1,6.32], respectively, P = 0.019). Hypothermic patients with one and more than one-episode also had longer PACU stays compared to normothermic patients (β[95%CI]:3.82[1.34,6.29] and 12.43[2.29,22.57] minutes, respectively, P = 0.001). No significant differences were observed in the other outcomes.
Intraoperative hypothermia in laparoscopic surgery is associated with a higher likelihood of intraoperative cardiac arrhythmias, prolonged PACU stay and higher postoperative oxygen requirement. Further research and prospective studies are warranted to validate these results and develop strategies to manage intraoperative hypothermia effectively.
本研究旨在探讨成人腹腔镜手术患者术中低体温与手术结局之间的关联。
对泰国宋卡纳卡林医院2020年至2021年期间接受治疗的2048例成人腹腔镜手术患者进行回顾性分析。术中低体温定义为核心体温低于36°C，记录为一次或多次发作。从医院信息系统中提取患者的人口统计学资料、临床信息和术后结局。结局指标包括术中及术后心律失常、术后吸氧需求、麻醉后监护病房（PACU）停留时间和住院时间。采用单因素和多因素逻辑/线性回归模型评估低体温与结局之间的关联，以比值比（OR）或β系数（β）及95%置信区间（CI）表示。
术中低体温的发生率为34.9%，其中688例经历一次发作，27例经历多次发作。多因素分析显示，与体温正常的患者相比，经历一次和多次低体温发作的患者术中发生心律失常的风险增加（OR [95%CI]：分别为1.67[1.24,2.25]和3.65[1.53,8.74]，P<0.001）。与仅经历一次低体温发作的患者相比，体温正常的患者和经历多次低体温发作的患者术后吸氧需求的几率更高（OR [95%CI]：分别为1.32[1.02,1.7]和2.64[1.1,6.32]，P = 0.019）。与体温正常的患者相比，经历一次和多次低体温发作的患者PACU停留时间也更长（β[95%CI]：分别为3.82[1.34,6.29]和12.43[2.29,22.57]分钟，P = 0.001）。在其他结局方面未观察到显著差异。
腹腔镜手术中的术中低体温与术中发生心律失常的可能性增加、PACU停留时间延长和术后吸氧需求增加有关。有必要进行进一步的研究和前瞻性研究来验证这些结果，并制定有效管理术中低体温的策略。
