Type of publication:
Conference abstract

Author(s):
Clulow C.; *Lewis B.; *Law R.

Citation:
Anaesthesia; Jul 2019; vol. 74 ; p. 71

Abstract:
The maintenance of normothermia during the peri-operative period is important in regulating homeostatic processes during physiological stress. Therefore, temperature monitoring is essential to avoid hypothermia or hyperthermia, which might complicate anaesthesia. Inadvertent peri-operative hypothermia (IPH) can contribute to many complications including coagulopathy, infection, delayed wound healing, increased hospital stay, cardiac events and death [1, 2]. Therefore, reducing the incidence of IPH could minimise the morbidity and mortality associated with this problem. Methods This was a prospective observational audit involving 102 cases. We analysed elective surgical cases coming from the Day Case Unit and the Surgical Admissions Suite from April to June 2018. Data collection was performed by the authors using a proforma based on the National Institute for Health and Care Excellence (NICE) clinical guideline 65 [1], and the Royal College of Anaesthetists audit recipe book [2]. We compared our results to the primary audit conducted in 2016. Results Only 9.8% of patients had a temperature recorded within 1 h of surgery. Less than 5% had a temperature < 36degreeC preoperatively. There was an improvement in prophylactically warming at-risk patients from 39.1% to 70.5%. Warming interventions in operations with duration > 30 min were used in 73% of cases in comparison to 39.2% previously. Temperature was measured every 30 min in only 24.3% of cases and 9.8% of cases left theatre 'cold', but none left recovery with a temperature < 36degreeC. Discussion IPH was reduced from 13.7% to 9.8%. The two factors identified that have the most influence on this is improved prophylactic intra-operative warming of the at-risk population and warming methods being used in operations lasting > 30 min. The suboptimal intraoperative monitoring was disappointing to see, but given few cases left theatre 'cold', it may be assumed that this was due to a deficiency in documentation rather than monitoring.

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