Heat balance and core and skin temperatures were studied in 111 patients during abdominal surgery. In minor surgical procedures the effects of heating of inspired humidified gases (n = 23) and of a heating mattress (n = 21) were compared with the conditions in an unwarmed control group (n = 24). These two methods were about equally effective in preserving total body heat, although the major effect of the heating mattress was to conserve heat which had been redistributed to the surface, and such heat could subsequently be lost to the environment. During major abdominal surgery 18 unwarmed control patients were compared with patients (n = 25) provided with a heat supply. The combined measures of heated humidified inspired gases, a heating mattress, insulation by a heat-reflecting blanket, warming of all infusions and transfusions and a warm operating room were all needed to balance the great heat losses during the major surgical procedures. With such massive heat supply it was possible to prevent heat loss and a fall in core temperature.
Heat loss during anaesthesia and surgery is a common problem. In patients with restricted cardio-pulmonary reserves this may endanger the postoperative outcome. In order to compare thermal balance we studied 25 men undergoing transurethral resection of the prostate (TURP), using either general anaesthesia (G.A.) or epidural analgesia (E.A.). Oxygen uptake, catecholamines, peripheral and central temperatures were followed in the per- and postoperative period. Heat production and total body heat were calculated from oxygen uptake and temperature measurements, respectively. Transurethral resection of the prostate resulted in a peroperative heat loss which was not influenced by the anaesthetic technique used and averaged 370 kJ during the first hour of surgery. G.A. reduced heat production while this was uninfluenced by E.A. After termination of general anaesthesia, oxygen uptake and plasma catecholamines increased, while no such changes could be detected using epidural analgesia. The ability to increase mean body temperature by increasing heat production was negatively correlated to age.
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