Perioperative Temperature Management

This practical text offers a comprehensive guide to perioperative temperature management for anaesthetists, surgeons and nurses. The physiological basics of thermoregulation and heat exchange are covered, before the changes that occur during general and regional anaesthesia are outlined. The relevant adverse scenarios associated with perioperative hypothermia, including morbid cardiac events, impairment of coagulation, increased blood loss and surgical site infections are discussed, before the methods of measuring core temperature and the equipment and techniques to keep patients warm are described. Richly illustrated and clearly structured for quick reference, Perioperative Temperature Management is an essential daily resource to help ensure safe, effective practice.

Part I. Introduction: 1. History of perioperative hypothermia; 2. Physiology of heat and cold sensation; 3. Physiology of thermoregulation; 4. Physiology of heat gain and heat loss; Part II. Changes Induced by Anaesthesia and Surgery: 5. Influence of preanaesthetic core temperature and premedication; 6. Influence of transportation to the operating room and preparation for surgery; 7. Influence of general anaesthesia; 8. Influence of regional anaesthesia; 9. Influence of regional anaesthesia and sedation; 10. Influence of epidural anaesthesia and general anaesthesia; 11. Influence of the surgical environment and surgery; Part III. Adverse Effects of Perioperative Hypothermia: 12. Incidence of perioperative hypothermia; 13. Influence on pharmacokinetics and pharmacodynamics; 14. Influence on coagulation and blood loss; 15. Feeling cold and shivering; 16. Postoperative pain, pulmonary complications and length of stay in the postanaesthetic care unit; 17. Cardiovascular consequences; 18. Influence on wound healing and infections; 19. Postoperative protein catabolism, length of stay, costs and mortality; Part IV. Measurement of Core Temperature: 20. Equipment to measure core temperature; 21. Measurement of core temperature; Part V. Equipment and Methods to Keep Patients Warm: 22. Forced-air warmers; 23. Conductive warmers; 24. Infusion warmers; 25. Warming of irrigation fluids; 26. Insulation; 27. Radiative warmers; 28. Airway heating and humidification; 29. Oesophageal warmers, negative pressure warmers and endovascular warming catheters; 30. Augmentation of heat production by amino acids or fructose; Part VI. Perioperative Temperature Management: 31. Modern perioperative temperature management; 32. Prewarming; 33. Warming therapy during anaesthesia; 34. Postoperative therapy; Index; References.

Professor Dr Anselm Bräuer DEAA is Consultant at the Department of Anaesthesiology at the University Hospital in Göttingen, Germany. Specialising in the detection, prophylaxis and treatment of hypothermia, he is co-author of the German and Austrian guideline for the prevention of inadvertent perioperative hypothermia.