Adverse effects of perioperative hypothermia Hypothermia within the perioperative phase may have many undesired physiological effects that are associated with postoperative morbidity (14). Many studies have shown that hypothermia in the perioperative period has been associated with several adverse effects, including impaired drug metabolism, prolonged recovery from anesthesia, elevation of plasma catecholamine concentration, cardiac morbidity, coagulopathy, impaired wound healing, wound infections, and postoperative shivering, systemic and pulmonary vasoconstriction, increased arterial blood pressure, sympathetic nervous system activation, variations in serum potassium levels, impaired neutrophils and macrophages and decreased partial …show more content…
The American Society of Peri-Anesthesia Nurses (ASPAN) established the first clinical guideline in the United States for the prevention of hypothermia. This guideline contains major recommendations for hypothermia prevention but does not include requirements for implementation (1). It provides direction for preoperative, intraoperative, and postoperative management of patient temperature and instructs nurses in preoperative assessment and interventions for hypothermia. Pre-operative care before arrival in the ward/accident and emergency department, and postoperative care beyond the initial 24-hour period following surgery are not covered by this guideline. Guidelines of the American Association of Nurse Anesthetists recommend patient body temperature monitoring during local, regional, and general surgical procedures, as deemed necessary. Similarly, the American Society of Anesthesiologists (ASA) recommends that temperature be evaluated continually during the administration of all anesthetics when clinically significant changes in body temperature are intended, anticipated, or suspected (24, …show more content…
Many different methods and sites of temperature measurement are used perioperatively (27). Perioperative temperature monitoring devices vary by transducer type and site monitored (15). There is evidence shows that for non-invasive temperature monitoring the oral route is the most reliable but suffers numerous limitations in intraoperative phase ; infrared ear temperature measurement is inaccurate. Axillary route of temperature measurement is the safest site and is helpful in patients who cannot have an oral temperature recording. The accuracy and precision of axillary site is less than that of other sites. Intraoperatively, acceptable semi-invasive temperature monitoring sites are the nasopharynx, oesophagus and urinary bladder (28). Monitoring of central temperatures among other vital signs is advisable in such interventions in order to detect temperature changes and check the efficacy of measures to prevent or treat hypothermia (10). Continued intraoperative monitoring of core temperature (ideally using esophageal probes) is recommended in all cases lasting more than 30 minutes. How core temperature is monitored depends on the clinical setting and, in surgery, on what procedure is planned