Influencing Factors Of Hypothermia And The Best Evidence For Hypothermia Management In Patients After General Anesthesia Lower Abdominal Surgery

Obj ective1.Observe the incidence of hypothermia after general anesthesia and the change of body temperature within 4 hours after transfer to PACU,explore the risk factors of hypothermia within 1 hour after transfer to PACU,and predict the population at high risk of hypothermia within 1 hour after transfer to PACU,so as to optimize the allocation of resources,actively prevent and rewarm.2.Based on the change characteristics within 4 hours after general anesthesia abdominal surgery patients transferred to PACU and the previous study on the related factors of hypothermia at 1 hour after transfer to PACU,the relevant evidence of hypothermia management after operation was searched and screened,graded and recommended,and the best evidence was summarized in order to standardize the management of hypothermia after operation and improve the nursing level of patients with hypothermia after operation.Methods1.Using convenience sampling method and self-designed data collection table,201 patient undergoing abdominal surgery under general anesthesia from December 2017 to March 2018 were collected for temperature changes and related clinical data within 4 hours after they were transferred to PACU.The influencing factors of hypothermia in abdominal surgery under general anesthesia within 1 hour after they were transferred to PACU were analyzed by single factor analysis and multi-factor logistic regression analysis.2.Searcing JBI Evidence-based Health Care Library,Up to date,National Technical Intelligence Guidance Network,Guidance International Network,Scottish Inter-hospital Guidance Network,New Zealand Clinical Guidance Website,Medical Maitong Guidelines Network,Cochrane Library,Pubmed,Embase,OVID,China Knowledge Network and Wanfang databases for all evidence on post-operative hypothermia management,including guidelines,experts Primitive studies such as consensus,evidence summary,systematic evaluation and randomized controlled trials.Results1.The incidence of hypothermia was 52.7%when patients were transferred to PACU after general anesthesia.The incidence of hypothermia was 28.4%at 1 hour after PACU.After 4 hours of PACU,the incidence of hypothermia decreased significantly.Multivariate logistic regression analysis showed that bleeding,preoperative heart rate and operation time were independent risk factors for hypothermia in patients undergoing general anesthesia abdominal surgery at 1 hour after PACU.2.Eight articles were included,including three guides,one expert consensus,two systematic reviews and two randomized controlled trials.Finally,13 best evidences were concluded.Conclusion1.Postoperative hemorrhage,preoperative heart rate<60 beats/min,operation time>2 hours after general anesthesia lower abdominal surgery patients transferred to PACU 1 hour after the incidence of hypothermia is higher,should be targeted at the relevant factors for general anesthesia lower abdominal surgery patients to implement reasonable,active prevention,intervention,effective rewarming.2.The evidence included in the study shows that medical staff should pay attention to temperature monitoring after operation.Anesthesia recovery room should measure patient's temperature at least once every 15-30 minutes.When entering and leaving anesthesia recovery room,temperature data must be recorded.It is recommended that patients with hypothermia after operation should be actively rewarmed.The quality of rewarming should be periodically reviewed every 3-6 months to provide guidance for rewarming.At present,there is an expert consensus in China.It is suggested that medical staff should transform evidence practice to ensure the quality of temperature management after operation and promote the rehabilitation of patients.