Incidence of peri-operative hypothermia – a unicentric, observational study

Authors: Obare Pyszková Lenka 1;  Nevtípilová Michaela 1;  Žáčková Dagmar 1;  Fritscherová Šárka 1;  Zapletalová Jana 2,3;  Hrabálek Lumír 3,4;  Adamus Milan 1,3
Authors‘ workplace: Klinika anesteziologie, resuscitace a intenzivní medicíny, Fakultní nemocnice Olomouc 1;  Ústav lékařské biofyziky, Institut molekulární a translační medicíny, Lékařská fakulta Univerzity Palackého v Olomouci 2;  Lékařská fakulta Univerzity Palackého v Olomouci 3;  Neurochirurgická klinika, Fakultní nemocnice Olomouc 4
Published in: Anest. intenziv. Med., 25, 2014, č. 4, s. 267-273
Category: Anaesthesiology - Original Paper


To study peri-operative temperature changes in patients during short and medium duration operations.

Unicentric, prospective, observational study.

Department of Anaesthesiology and Intensive Care, University Hospital.

Materials and methods:
We measured patients’ peri-operative temperature during a period of 59 working days (June – August 2013). Using the anaesthetic chart we recorded the age, sex, type of surgical operation, duration of anaesthesia, use/no use of temperature management devices and electronic measurement of theatre temperature. No correlation between the BMI, infusion therapy and peri-operative hypothermia was observed in the study.

Total 401 patients were enrolled in the study. Postoperative hypothermia (temperature drop > 0.5 °C) was observed in 253 patients (63%) at PACU admission. After anaesthesia, there was a significant decrease in the temperature compared to the pre-operative temperature (Wilcoxon paired rank sum test p < 0.0001). Temperature recordings were also significantly lower after PACU discharge when compared to the pre-operative temperature. (Wilcoxon paired rank sum test p < 0.0001). Similarly, the body temperature after PACU discharge was significantly higher than postoperatively (Wilcoxon paired rank sum test p < 0.0001). There were low correlations between changes in temperature after anaesthesia and the duration of operation (Spearman correlation coefficient r = -0.299) and with theatre temperature (Spearman correlation coefficient r = 0.168). No correlation was observed between the temperature change after anaesthesia and the patients’ age (r = -0.065) nor between the temperature change and the patients’ sex.

Body temperature decrease during general anaesthesia occurs even during short surgical procedures.

peri-operative hypothermia – complications – general anaesthesia – body temperature – post-anaesthesia care unit


1. Shah, J. B., Hudson, J. C., Keenan, R. L., Simpson, P. M., Tyler, B., Kane, F. Hypothermia and its impact in the postanesthesia care unit. Anesthesiology, 1992, 77, 3A, p. A1057.

2. Uebelen, R., Schulze, K., Muller, D., Rueckoldt, H. Unintended decreasing body temperature: A stepchild of perioperative care and outcome consequence. Br. J. Anaesth., 1998, 80, A26.

3. Mahoney, C. B, Odom, J. Maintaining intraoperative normothermia: A meta-analysis of outcomes with costs. AANA J., 1999, 67, 2, p. 155–164.

4. Monzón, C. G. C., Arana, C. A. C., Valz, H. A. M., Rodríguez, F. A., Mejía, J. J. B., Gómez, J. A. A. Temperature management during the perioperative period and frequency of inadvertent hypothermia in a general hospital. Colombian Journal of Anesthesiology, 2013, 41, 2, p. 97–103.

5. Kiekkas, P., Poulopoulou, M., Papahatzi, A., Souleles, P. Effects of hypothermia and shivering on standard PACU monitoring of patients. AANA J., 2005, 73, 1, p. 47–53.

6. Leslie, K., Sessler, D. I., Bjorksten, A. R., Moayeri, A. Mild hypothermia alters propofol pharmacokinetics and increases the duration of action of atracurium. Anesth. Analg., 1995, 80, 5, p. 1007–1014.

7. De Brito Poveda, V., Clark, A. M., Galvão, C. M. A systematic review on the effectiveness of prewarming to prevent perioperative hypothermia. J. Clin. Nurs., 2013, 22, 7–8, p. 906–918.

8. Torossian, A., TEMMP (Thermoregulation in Europe Monitoring and Managing Patient Temperature) Study Group. Survey on intraoperative temperature management in Europe. Eur. J. Anaesthesiol., 2007, 24, 8, p. 668–675.

9. Sessler, D. I. Perioperative heat balance. Anesthesiology, 2000, 92, 2, p. 578–596.

10. Buggy, D. J., Crossley, A. W. A. Thermoregulation, mild perioperative hypotermia and postanaesthetic shivering. Br. J. Anaesth., 2000, 84, p. 615–628.

11. Frank, S. M., Fleisher, L. A., Breslow, M. J., Higgins, M. S., Olson, K. F., Kelly, S., Beattie, C. Perioperative maintenance of normothermia reduces the incidence of morbid cardiac events. A randomized clinical trial. JAMA, 1997, 277, 14, p. 1127–1134.

12. Rajagopalan, S., Mascha, E., Na, J., Sessler, D. I. The effects of mild perioperative hypothermia on blood loss and transfusion requirement. Anesthesiology, 2008, 108, 1, p. 71–77.

13. Kurz, A., Sessler, D. Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. N. Engl. J. Med., 1996, 334, 19, p. 1209–1215.

14. Matsukawa, T., Sessler, D. I., Sessler, A. M., Schroeder, M., Ozaki, M., Kurz, A., Cheng, C. Heat flow and distribution during induction of general anesthesia. Anesthesiology, 1995, 82, 3, p. 662–673.

15. Kumar, S., Wong, P. F., Melling, A. C., Leaper, D. J. Effects of perioperative hypothermia and warming in surgical practice. Int. Wound. J., 2005, 2, 3, p. 193–204.

16. Herold, I., Černý, V., Cvachovec, K. (eds.) Doporučení pro poskytování poanestetické péče. Doporučené postupy a stanoviska ČSARIM, 2011. [online], [cit. 2013-11-17]. Dostupný z www:

17. Guidelines for perioperative cardiovascular evaluation and management for noncardiac surgery (JCS 2008) digest version. JCS Joint Working Group. Circ J., 2011, 75, 4, p. 989–1009.

18. Sessler, D. I. Temperature monitoring and perioperative thermoregulation. Anesthesiology, 2008, 109, 2, p. 318–338.

19. Höcker, J., Bein, B., Böhm, R., Steinfath, M., Scholz, J., Horn, E. P. Correlation, accuracy, precision and practicability of perioperative measurement of sublingual temperature in comparison with tympanic membrane temperature in awake and anaesthetised patients. Eur. J. Anaesthesiol., 2012, 29, 2, p. 70–74.

20. Moola, S., Lockwood, C. Effectiveness of strategies for the management and/or prevention of hypothermia within the adult perioperative environment. Int. J. Evid. Based Health., 2011, 9, 4, p. 337–345.

21. Inadvertent perioperative hypothermia. The management of inadvertent perioperative hypothermia in adults. National Institute for Health and Clinical Evidence. Clinical practice guidelines, 2008. [online], [cit. 2013-11-17]. Dostupný z www: a

22. Fernandes, L. A., Braz, L. G., Koga, F. A., Kakuda, C. M., Módolo, N. S., de Carvalho, L. R., Vianna, P. T., Braz, J. R. Comparison of peri-operative core temperature in obese and non-obese patients. Anaesthesia, 2012, 67, 12, p. 1364–1369.

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