Skip to main content

Advertisement

SpringerLink
Log in

What is the predictor of the intraoperative body temperature in abdominal surgery?

  • Original Article
  • Published:
Journal of Anesthesia Aims and scope Submit manuscript

Abstract

Purpose

Inadvertent hypothermia is a relatively common intraoperative complication. Few studies have investigated predictors of body temperature change or the effect of the blanket type used with a forced-air warming device during the intraoperative period. We investigated the predictive factors of intraoperative body temperature change in scheduled abdominal surgery.

Methods

We retrospectively reviewed the data from 2574 consecutive adult patients who underwent scheduled abdominal surgery in the supine position. Temperature data were collected from anesthesia records. Multiple regression analysis was performed at 60, 120, and 180 min after the surgical incision to identify the factors influencing body temperature change. We conducted nonlinear regression analysis using the equation ΔT = α (e−γt—1) + βt, where ΔT represented the change in intraoperative core temperature (°C), t represented the surgical duration (minutes), and α, β, and γ were constants.

Results

The intraoperative core temperature change was explained by the equation ΔT = 0.59 (e− 0.018t − 1) + 0.0043t. Younger age, higher body mass index (BMI), male sex, laparoscopic surgery, and use of an underbody blanket were associated with increased core temperature at 1 or 2 h after surgical incision. Male sex and an underbody blanket remained strong predictive variables even 3 h after surgical incision, whereas BMI had little explanatory power at this timepoint. The difference in the heating effect of an underbody versus an overbody blanket was 0.0012 °C per minute.

Conclusions

The blanket type of the forced-air warmer, age, sex, laparoscopic surgery, and BMI are predictors of intraoperative core temperature change.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Greif R, Laciny S, Rajek A, Doufas AG, Sessler DI. Blood pressure response to thermoregulatory vasoconstriction during isoflurane and desflurane anesthesia. Acta Anaesthesiol Scand. 2003;47:847–52.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Royse CF, Liew DF, Wright CE, Royse AG, Angus JA. Persistent depression of contractility and vasodilation with propofol but not with sevoflurane or desflurane in rabbits. Anesthesiology. 2008;108:87–93.

    Article  CAS  PubMed  Google Scholar 

  3. Chen A, Ashburn MA. Cardiac effects of opioid therapy. Pain Med. 2015;16(Suppl 1):27–31.

    Article  Google Scholar 

  4. Sessler DI, McGuire J, Moayeri A, Hynson J. Isoflurane-induced vasodilation minimally increases cutaneous heat loss. Anesthesiology. 1991;74:226–32.

    Article  CAS  PubMed  Google Scholar 

  5. Sessler DI. Temperature monitoring and perioperative thermoregulation. Anesthesiology. 2008;109:318–38.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Frank SM, Fleisher LA, Breslow MJ, Higgins MS, Olson KF, Kelly S, Beattie C. Perioperative maintenance of normothermia reduces the incidence of morbid cardiac events. A randomized clinical trial. JAMA. 1997;277:1127–34.

    Article  CAS  PubMed  Google Scholar 

  7. Rajagopalan S, Mascha E, Na J, Sessler DI. The effects of mild perioperative hypothermia on blood loss and transfusion requirement. Anesthesiology. 2008;108:71–7.

    Article  Google Scholar 

  8. Schmied H, Kurz A, Sessler DI, Kozek S, Reiter A. Mild hypothermia increases blood loss and transfusion requirements during total hip arthroplasty. Lancet. 1996;347:289–92.

    Article  CAS  PubMed  Google Scholar 

  9. Kurz A, Sessler DI, Lenhardt R. Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. Study of Wound Infection and Temperature Group. N Engl J Med. 1996;334:1209–15.

    Article  CAS  Google Scholar 

  10. Zhou J, Poloyac SM. The effect of therapeutic hypothermia on drug metabolism and response. Cellular mechanisms to organ function. Expert Opin Drug Metab Toxicol. 2011;7:803–16.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Sun Z, Honar H, Sessler DI, Dalton JE, Yang D, Panjasawatwong K, Deroee AF, Salmasi V, Saager L, Kurz A. Intraoperative core temperature patterns, transfusion requirement, and hospital duration in patients warmed with forced air. Anesthesiology. 2015;122:276–85.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Han SB, Gwak MS, Choi SJ, Ko JS, Kim GS, Son HJ, Shin JC. Risk factors for inadvertent hypothermia during adult living-donor liver transplantation. Transpl Proc. 2014; 46: 705–8.

    Article  Google Scholar 

  13. Kasai T, Hirose M, Yaegashi K, Matsukawa T, Takamata A, Tanaka Y. Preoperative risk factors of intraoperative hypothermia in major surgery under general anesthesia. Anesth Analg. 2002;95:1381–3. table of contents.

    Article  CAS  PubMed  Google Scholar 

  14. Yang L, Huang CY, Zhou ZB, Wen ZS, Zhang GR, Liu KX, Huang WQ. Risk factors for hypothermia in patients under general anesthesia: is there a drawback of laminar airflow operating rooms? A prospective cohort study. Int J Surg. 2015;21:14–7.

    Article  PubMed  Google Scholar 

  15. Sessler DI. Temperature regulation and monitoring. In: Miller RD, editor. Miller’s anesthesia. Eighth edition. Philadelphia: Elsevier Health Sciences; 2015. p. 1627.

    Google Scholar 

  16. Bräuer A, English MJ, Lorenz N, Steinmetz N, Perl T, Braun U, Weyland W. Comparison of forced-air warming systems with lower body blankets using a copper manikin of the human body. Acta Anaesthesiol Scand. 2003;47:58–64.

    Article  PubMed  Google Scholar 

  17. Hardy JD, Du Bois EF. Differences between men and women in their response to heat and cold. Proc Natl Acad Sci U S A. 1940;26:389–98.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Bal NC, Maurya SK, Sopariwala DH, Sahoo SK, Gupta SC, Shaikh SA, Pant M, Rowland LA, Bombardier E, Goonasekera SA, Tupling AR, Molkentin JD, Periasamy M. Sarcolipin is a newly identified regulator of muscle-based thermogenesis in mammals. Nat Med. 2012;18:1575–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Erdling A, Johansson A. Core temperature–the intraoperative difference between esophageal versus nasopharyngeal temperatures and the impact of prewarming, age, and weight: a randomized clinical trial. AANA J. 2015;83:99–105.

    PubMed  Google Scholar 

  20. Kurz A, Plattner O, Sessler DI, Huemer G, Redl G, Lackner F. The threshold for thermoregulatory vasoconstriction during nitrous oxide/isoflurane anesthesia is lower in elderly than in young patients. Anesthesiology. 1993;79:465–9.

    Article  CAS  PubMed  Google Scholar 

  21. Nguyen NT, Fleming NW, Singh A, Lee SJ, Goldman CD, Wolfe BM. Evaluation of core temperature during laparoscopic and open gastric bypass. Obes Surg. 2001;11:570–5.

    Article  CAS  PubMed  Google Scholar 

  22. Stewart BT, Stitz RW, Tuch MM, Lumley JW. Hypothermia in open and laparoscopic colorectal surgery. Dis Colon Rectum. 1999;42:1292–5.

    Article  CAS  PubMed  Google Scholar 

  23. Song C, Tang B, Campbell PA, Cuschieri A. Thermal spread and heat absorbance differences between open and laparoscopic surgeries during energized dissections by electrosurgical instruments. Surg Endosc. 2009;23:2480–7.

    Article  CAS  PubMed  Google Scholar 

  24. Umenai T, Nakajima Y, Sessler DI, Taniguchi S, Yaku H, Mizobe T. Perioperative amino acid infusion improves recovery and shortens the duration of hospitalization after off-pump coronary artery bypass grafting. Anesth Analg. 2006;103:1386–93.

    Article  CAS  PubMed  Google Scholar 

  25. Inoue S, Shinjo T, Kawaguchi M, Nakajima Y, Furuya H. Amino acid infusions started after development of intraoperative core hypothermia do not affect rewarming but reduce the incidence of postoperative shivering during major abdominal surgery: a randomized trial. J Anesth. 2011;25:850–4.

    Article  PubMed  Google Scholar 

  26. Morris RH, Wilkey BR. The effects of ambient temperature on patient temperature during surgery not involving body cavities. Anesthesiology. 1970;32:102–7.

    Article  CAS  PubMed  Google Scholar 

  27. Morris RH. Operating room temperature and the anesthetized, paralyzed patient. Arch Surg. 1971;102:95–7.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

We thank Kelly Zammit, BVSc, from Edanz Group, for editing a draft of this manuscript.

Author information

Authors and Affiliations

  1. Operating Rooms, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Ryohei Miyazaki

  2. Department of Anesthesiology and Critical Care Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    Sumio Hoka

Authors
  1. Ryohei Miyazaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sumio Hoka
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ryohei Miyazaki.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Miyazaki, R., Hoka, S. What is the predictor of the intraoperative body temperature in abdominal surgery?. J Anesth 33, 67–73 (2019). https://doi.org/10.1007/s00540-018-2585-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00540-018-2585-6

Keywords

Search

Navigation