Perioperative hypothermia in elective surgical patients

Introduction: Perioperative hypothermia is an under-reported, yet well recognized complication of surgery. Normal thermoregulatory mechanisms are disrupted in anesthetized patients. Up to 70% of surgical patients develop perioperative hypothermia, with serious consequences including coagulopathy, sepsis and cardiac events. Methods: In this single centre study, we collected prospective data from 100 elective operations in urology, gynaecology, general and breast surgery. The pre-operative, pre-induction, intraoperative, post-procedure and in recovery temperatures (in Celsius) were recorded. Any temperature below the 36°C was regarded as hypothermia and the total incidence of hypothermia during all the 5 phases were calculated. Results: Incidences of hypothermia in pre-operative, pre-induction, intraoperative, post-procedure and in-recovery were 4 %, 5%, 12 %, 11 %, 8 % and 6 % respectively. Multiple regression analysis of pre-operative, pre-induction and intra-operative temperatures resulted in a p value of 0.237 for pre-operative temperature and 0.000032577 for pre-induction temperatures respectively. This suggests that pre-induction temperature was the most statistically significant parameter for intra-operative hypothermia. Furthermore, regression analysis predicted the intra-operative temperature for a given pre-induction temperature. Regression analysis line fit plot between preinduction and intra-operative temperatures predicted that for intraoperative temperature to be 36.74 °C, mean preinduction temperature is to be raised to 37.2 °C. Conclusion: This study highlights the incidence of intraoperative hypothermia and need for active interventions to prevent the same. It paves the way for a single blinded randomized controlled trial for comparing different modalities to pre-warm patients and prevent intraoperative hypothermia.