Prevalence of Perioperative Hypothermia Amongst Patients Undergoing Anesthesia at the Kenyatta National Hospitaltheatres

Abstract

Background During surgical procedures, patients in operating suites are exposed to varying thermal challenges that can lead to perioperative hypothermia1 a core body temperature of ≤36.0°C. Hypothermia is also a common consequence of administration of anesthesia to patients. Rational medical practice demands therefore that anesthesiologists responsible for the patients preoperatively, intraoperatively and postoperatively should monitor their patients’ temperatures regularly and maintain the patients in normothermic state by using warm intravenous fluids, thermal blankets, forced air warming and blankets. Broad Objective: This study sought to determine the prevalence of perioperative hypothermia under both general and spinal anesthesia at the operating theatres of Kenyatta National Hospital. The study sought to establish prevalence of hypothermia amongst adult patients undergoing spinal or general anesthesia and determine the associated risk factors present in our set up. Study Design: It was a prospective observational study. Study Site: The study was conducted at the Kenyatta National Hospital main theatre and satellite theatres. Study population: The study was conducted on male and female patients above 18years old undergoing elective or emergency surgery. The patients were of ASA 1,2 or 3. Sampling Methods: The sampling procedure was convenience sampling from the emergency and elective theatre lists until the desired sample size was achieved using Fischer’s formula. The total number of patients being 165. 6 Study Duration: The study took 3 months. Data Analysis: Data was entered and analyzed with the use of Statistical Package for Social Sciences (SPSS) version 21. Socio-demographic and clinical characteristics were summarized and presented as frequencies and proportions, as well as mean and standard deviations, and medians with interquartile ranges where applicable. The prevalence of hypothermia amongst adult surgical patients undergoing spinal anaesthesia and general anaesthesia was analyzed and presented as frequencies and proportions. Result and Conclusions: The study has shown that perioperative hypothermia was prevalent at 70.7% among all patients undergoing the study. It was noted that 90.9% of patients above 55 years had perioperative hypothermia. Contrary to other studies it was noted patients who had a BMI between 18.5-24.9 were more hypothermic at 70.1%. The study also showed that patients who underwent procedures between 1-2hours were more hypothermic at 71.9%. The study further revealed that the use of spinal anesthesia had a higher prevalence of hypothermia at 76.9% than those who underwent general anesthesia. It was also noted that patients who underwent obstetric (41.7%) and orthopedic procedures(31.7%) had a higher prevalence of perioperative hypothermia. The study also showed that the use of adequate linen and warm intravenous fluids reduced the prevalence of hypothermia