Incidence and Distribution of Inadvertent Severe Intraoperative Hypothermia During Cancer Surgery: a Retrospective Single Center Study

Abstract

Background: Inadvertent perioperative mild hypothermia is a common side effect of anesthesia and surgery. This complication has multiple origins. Hypothermia can negatively affect postoperative outcome. However, it might be prevented by specific measures. Objectives: As part of a quality assurance program, we assessed the incidence of severe intraoperative hypothermia in association with specific surgery and procedures. The next step consisted of a series of measures to decrease its incidence. Patients and Methods: After approval of our institutional review board, we used our computerized recording of anesthesia and postoperative care chart database (DEIO Archive Browser®) to extract the anesthetic files of patients who have experienced severe and mild hypothermia (< 34.5°C) and (≥ 34.5°C and < 35.5°C) between 2005 and 2006. Results: A total of 12780 patients were screened between 2005 and 2006, 36 patients in 2005 and 38 in 2006 had severe hypothermia. A high percentage (33%) of peripheral surgery (breast surgery) was found in this group of patients. The percentage of mild hypothermia was around 0.5%. After analysis and discussion in the Quality Control Management meeting, several basic suggestions were made. Consequently, the number of patients experiencing severe hypothermia decreased by 50% in 2007, but the percentage of mild hypothermia did not change. Conclusions: This study revealed the incidence of severe intraoperative hypothermia in our cancer hospital and we managed to decrease this incidence by simple measures. In addition, it suggests that severe hypothermia does not occur only in prolonged surgery and measures to prevent this complication should be undertaken for all patients. Automated anesthesia recording file is a useful tool to monitor the quality assurance program pertaining intraoperative hypothermia.