106 - Preliminary Data on the Incidence of Hypothermia in Intraoperative Wake-up Neurosurgery
Clinical Issue: Perioperative hypothermia (body temperature < 36?) is a common phenomenon, which accounts for about half of all surgical patients. It is directly involved many major adverse events. Many studies had focused on different type of surgery, but there isn’t any data on the incidence of hypothermia in intraoperative wake-up neurosurgery. The anesthesia method of this surgery is different and there is an awake period during the surgery. In this study, we aimed to explore the changes of body temperature and the incidence of hypothermia in patients undergoing intraoperative wake-up surgery to reduce perioperative complications and improve the perioperative heat preservation process. Description of Team: We come from the operating room of Shanghai Huashan Hospital affiliated to Fudan University, China. Team members Dongwei Xie is OR stuff nurse and Gendi Li is OR head nurse.Preparation and Planning: 14 patients who underwent elective intraoperative wake-up surgery in our hospital were selected, who were admitted to PACU after anesthesia. Exclusion criteria: Patients with ear canal diseases, abnormal body temperature regulation including malignant hyperthermia (MHS) and neurotranquilizer malignant syndrome, hypothyroidism or hyperthyroidism with clear evidence, autonomic nervous dysfunction, preoperative core temperature over 37.8?, infectious fever within 3 days.
Assessment: Our hospital is a tertiary general teaching hospital with 34 operating rooms. The annual operation volume is about 35000. There are 90 surgical nurses, all are college graduates or above. Implementation: Patients were admitted to the waiting area of the operating room in advance, who were given passive prewarming for 30 minutes before anesthesia. Temperature was monitored continuously by thermometric catheter. The general information including condition of patients, intraoperative fluid volume, anesthesia and operation length, anesthesia recovery time as well as perioperative core body temperature and hypothermia incidence were recorded. Thermometric catheter was applied for body temperature monitor 5 minutes prior to anesthesia, 15, 30, and 60 minutes post-anesthesia and every half hour post-anesthesia subsequently (including craniotomy, first wake-up, closed cranial,exiting the operating room). Outcome: Hypothermia occured in 7 of the 14 patients, the incidence was 50%, with the lowest core body temperature being 34.6?. At the time of craniotomy, the body temperature decreased significantly, with the average body temperature being 36.15 ± 0.57?. The average body temperature was lower than 36 ? in 6 patients.Implications for Perioperative Nursing: Since there is still a risk of hypothermia during the perioperative period of wake-up surgery in neurosurgery, it is necessary to take warming menthods to prevent hypothermia, reduce postoperative complications and accelerate the recovery of patients.