Impact of intraoperative hypothermia on the recovery period of anesthesia in elderly patients undergoing abdominal surgery

Abstract

Background: This study aimed to investigate the impact of intraoperative hypothermia on the recovery period of anesthesia in elderly patients undergoing abdominal surgery.

Methods: A prospective observational study was conducted based on inclusion and exclusion criteria. A total of 384 elderly patients undergoing abdominal surgery under general anesthesia were enrolled in a grade A tertiary hospital in Chengdu, Sichuan Province from October 2021 and October 2022. After anesthesia induction, inflatable warming blankets were routinely used for active heat preservation, and nasopharyngeal temperature was monitored to observe the occurrence of intraoperative hypothermia. Patients were divided into hypothermia group and nonhypothermia group according to whether hypothermia occurred during the operation. Anesthesia recovery time and the incidence of adverse events or unwanted events during anesthesia recovery between the two groups were compared.

Results: The numbers (percentage) of 384 patients who underwent abdominal surgery developed intraoperative hypothermia occurred in 240 (62.5%) patients, all of whom had mild hypothermia. There were statistically significant differences between mild hypothermia after active warming and nonhypothermia in the occurrence of shivering (χ2 = 5.197, P = 0.023) and anesthesia recovery time (Z = -2.269, P = 0.02) in elderly patients undergoing abdominal surgery during anesthesia recovery, and there were no statistically significant differences in hypoxemia, nausea or vomiting, hypertension, hypokalemia, hypocalcemia, analgesic drug use,postoperative wound infection or postoperative hospitalization days.

Conclusions: The incidence of intraoperative mild hypothermia after active warming was high in elderly patients who underwent abdominal surgery. Mild hypothermia increased the incidence of shivering and prolonged anesthesia recovery time in elderly patients undergoing abdominal surgery.

Keywords: Abdominal surgery; Anesthesia recovery; Elderly patients; Hypothermia.

Fig. 1

Flowchart of the study summarizing the steps used for patient selection

Fig. 2

Trends in mean core body temperature of patients at different time points. T0: at the end of anesthesia induction; T1: 0.5h after anesthesia; T2: 1h after anesthesia; T3: 1.5h after anesthesia; T4: 2h after anesthesia; T5: 2.5h after anesthesia; T6: 3h after anesthesia; T7: 3.5h after anesthesia; T8: 4h after anesthesia; T9: 4.5h after anesthesia; T10: 5h after anesthesia; T11: 5.5h after anesthesia; T12: 6h after anesthesia