Related factors of perioperative low body temperature and incidence of postoperative shivering in patients undergoing complex percutaneous nephrolithotomy and the effect analysis of composite insulation nursing intervention

Abstract

This study aimed to analyze the factors associated with intraoperative hypothermia and postoperative shivering rates in patients undergoing complex percutaneous nephrolithotomy (PCNL) and investigate the effects of combined insulation nursing intervention. A total of 168 patients were included, with 103 patients in the control (Ctrl) group receiving routine care and 65 patients in the nursing (Nur) group receiving combined insulation nursing intervention measures. General information, surgical data, temperature, intraoperative hypothermia incidence, postoperative shivering, and complication rates were statistically analyzed between the two groups. Patient temperature, blood pressure, and blood gas indicators including pH value, bicarbonate, and lactate levels were recorded at admission (T0), before anesthesia (T1), 30 min after spinal-epidural combined anesthesia (T2), 60 min (T3), 90 min (T4), 120 min (T5), and postoperatively (T6). The results demonstrated that the average intraoperative temperature of patients in the Nur group was significantly higher than that of the Ctrl group (P < 0.001), and their incidence of hypothermia was significantly lower than that of the Ctrl group (P < 0.01). Additionally, the Nur group exhibited shorter recovery time (18.36 ± 3.58 min), extubation time (28.01 ± 3.12 min), and length of hospital stay (8.45 ± 2.14 days) compared to the Ctrl group (P < 0.05). The incidence of postoperative shivering was 4.62 %, significantly lower than that of the Ctrl group (P < 0.001). Multifactorial analysis revealed that age ≥60 years, stone diameter ≥3.0 cm, irrigation volume ≥3000 mL, nursing intervention measures, and surgical duration were the main factors influencing the occurrence of intraoperative hypothermia. Age ≥60 years, nursing intervention measures, surgical duration, and intraoperative temperature<36 °C are identified as major risk factors for postoperative shivering. This indicates that specialized nursing care and combined insulation nursing intervention measures in patients undergoing complex percutaneous nephrolithotomy contribute to reducing the incidence of intraoperative hypothermia and postoperative shivering. It is recommended to promptly address the risk factors associated with hypothermia and shivering during and after surgery to mitigate the risk of perioperative complications.

Fig. 1

Comparison of body temperature changes in two groups of patients at various time points. (***P < 0.001 vs. Ctrl.).

Fig. 2

Comparison of the incidence of intraoperative hypothermia in two groups at various time points. (*P < 0.05, **P < 0.01, ***P < 0.001 vs. Ctrl.).

Fig. 3

Comparison of operation center rates of patients between groups in various time periods. (*P < 0.05, **P < 0.01 vs. Ctrl.).

Fig. 4

Comparison of intraoperative SBP in two groups of patients at various time points.

Fig. 5

Comparison of intraoperative DBP in two groups of patients at various time points.

Fig. 6

Comparison of blood gas indicators between the two groups at different time points. (A: pH value; B: base excess; C: lactate levels) (*P < 0.05 vs. Ctrl.).