An evidence-based guideline on preoperative warming of patients undergo general anesthesia to reduce postoperative hypothermia

Abstract

Operating theatre is a cold environment and hypothermia (core body temperature lower than 36C) is prevalent among patients undergoing operations. Possible causes of this adverse condition include anesthetic effect, body part exposure, blood loss, and the low room temperature in the theatre. Hypothermia can impair wound healing, decrease drug metabolism, increase oxygen consumption, which in turn causing respiratory distress, bradycardia as well as atrial fibrillation. In extreme cases, it can be lethal.

Numerous research studies have explored ways of interventions and new technologies to maintain normal body temperature of patients during operations. However, perhaps without proper translation to clinical practice, the rate of postoperative hypothermia still remains high in many hospital setting.

The objectives of this thesis are to systematically review the current literature on the effectiveness of preoperative warming on reducing postoperative hypothermia of patients undergoing general anesthesia. Data from the relevant literature is extracted for setting up a table of evidence. Also, quality assessment is performed. An evidence-based practice guideline for preoperative warming is developed and its feasibility and transferability to the target patients is examined. The purpose of the guideline is to provide better care for patients undergoing general anesthesia.

In this thesis, preoperative forced air warming is proposed. The target setting is the operating theatre department and day surgery centre in a local public acute hospital. The target population is patients who undergo general anesthesia. Data is extracted from six articles. The implementation potential of the proposed guideline is high, because of the high transferability, feasibility and cost-effective ratio. An evidence-based practice guideline is developed based on the evidence. Well-designed implementation and evaluation plan are developed for the implementation of the proposed guideline.