Author:

Keywords:

inadvertent hypothermia - orthopedic suregry - abdominal surgery - lumbar surgery

Abstract:

Background The ASPAN’s guideline for the promotion of perioperative normothermia recommends the use of prewarming for a minimum of 30 minutes to reduce the risk of hypothermia (1). During the last years industry developed new devices for active prewarming. The use of it is limited because of insufficient evidence and high costs. Purpose of the study This study was conducted as part of preparatory work for a randomized controlled trial assessing the effect of active prewarming on patients core temperature. Methods Core temperature was measured preoperative and immediately postoperative on recovery with a tympanic thermometer in adult patients who underwent an abdominal, orthopedic or lumbar neurosurgical procedure between July 2012 and February 2014. Procedures longer than 150 minutes were excluded. Hypothermia was defined as a temperature <35°C. Results In this study 162 patients were included. 28% underwent an abdominal, 32% an orthopedic and 40% a lumbar neurosurgical procedure. Mean temperature in the preoperative period was 36,3°C. There were no patients with hypothermia in the preoperative period and there was no significant difference in temperature between abdominal, orthopedic and neurosurgical patients (p=0,247). Immediately after surgery the mean temperature was 34,9°C and 52% of the patients had hypothermia, 41% had a decreased temperature and only 7% had normothermia. After surgery 63% of the abdominal patients and 58% of the orthopedic patients had hypothermia. The percentage of patients with hypothermia after lumbar neurosurgery was 39% (p=0,009). Implications for perioperative nursing These results show us the ongoing necessity for improving the standard care for patients undergoing a surgical procedure. Nurses can have an important role in the prevention of inadvertent hypothermia by using active prewarming. Further studies assessing the effect of active prewarming are recommended. Bibliography 1. Hooper VD, Chard R, Clifford T et al. ASPAN’s Evidence-Based Clinical Practice Guideline for the Promotion of Perioperative Normothermia: Second Ediction. Journal of PeriAnesthesia Nursing, 2010; Vol25, No6: 346-365