Fatores relacionados à perda de calor corporal no intra-operatório: análise de duas intervenções de enfermagem

Abstract

RESUMOA perda de calor corporal é comum durante procedimentos anestésicos-cirúrgicos. Este estudo analisou a influencia dos fatores -anestesia, fluídos endovenosos -aquecidos ou não, Índice de Massa Corpórea, temperatura e umidade da sala cirúrgica -envolvidos na perda de calor corporal de pacientes cirúrgicos idosos durante o período intra-operatório, identificando a variação da temperatura corporal. O estudo foi experimental fatorial, de campo, com abordagem quantitativa. Oitenta e um idosos, submetidos a cirurgias eletivas, com tempo cirúrgico mínimo de uma hora foram divididos por técnica de amostragem probabilística sistemática em dois Grupos: Experimentais e um Controle. Os dados foram coletados em um hospital do norte do Paraná, de dezembro de 1999 a fevereiro de 2000, por meio de termômetro timpânico, pela própria pesquisadora. Não houve relação estatisticamente significativa entre os fatores estudados e a variação da temperatura corporal, demonstrando que, neste estudo, a anestesia, o volume e aquecimento de fluídos endovenosos, Índice de Massa Corpórea e temperatura e umidade da sala cirúrgica não influenciaram na perda de calor corporal dos pacientes estudados durante o período intraoperatório. Estes achados indicam a necessidade das Salas Cirúrgicas proverem de tecnologias para controle da hipotermia intra-operatória, como colchão térmico e mantas aquecidas, especialmente para a população idosa. ABSTRACTThis study analyzed the influence of factors such as anesthesia and endovenous fluids, whether heated or not, Body Mass Index, temperature and humidity of operating room involved in body heat loss in elderly surgical patients during the intraoperatory period identifying body temperature variance. This was an experimental, comparative field study with a quantitative approach. Eighty-one elderly patients who underwent elective surgery

Tympanic and Temporal Thermometry in Hypothermia Assessment for Adult in Intraoperative Abdominal Surgery

“…In the list of variables, the results of this research confirm that anesthesia did not influence the loss of body heat of patients in the intraoperative period, 8 however, the literature indicates that combined anesthesia presents a situation of increased risk of intraoperative hypothermia. 22 Research with patients in the intraoperative period of abdominal surgery, which used TT, found that combined anesthesia was a statistically significant variable to predict hypotermia.…”

“…[18][19] Research that specifically analyzed the factors related to the loss of body heat in the intraoperative period did not include the ASA as a variable in the study. 8 In a study in Spain with adults undergoing some kind of elective surgery, the association between ASA classification and hypothermia was also rejected. 16 However, the National Institute for Health and Care Evidence (NICE) considers patients to be at high risk of perioperative hypothermia when they have two or more of the following risk factors: ASA greater than I, preoperative temperature below 36°C, combined and regional anesthesia, medium and extensive surgery, and patients with cardiovascular history.…”

“…4 When invasive thermometry methods are not available, non-invasive techniques are used (oral, axillary, tympanic or temporal artery). 7 In this study, tympanic (TT) and temporal (TTE) thermometry were used because TT is considered the most trustworthy in terms of the thermoregulatory center temperature in the hypothalamus; 8 TTE was introduced in the 1990s as a measure that records temperatures comparable with the core temperature, and since then, studies have been conducted to test its accuracy and reliability. 9 One study on the accuracy of TT found that it is a method that can be used in clinical practice due to its safety, ease of use and the rapid speed of temperature reading.…”

“…24 Research corroborates the findings of this study in which the temperature of the operating room did not influence the loss of body heat of patients in the intraoperative period, although this result was evident in elderly patients. 8 The recommended parameters for the tem-perature of the operating room were not followed in other studies. [2][3]13 A study conducted in Fortaleza-CE (Brazil), showed that in 120 surgical procedures, the room temperatures were not in accordance with the recommendations, achieving a minimum of 18.1 o C. 3 In another study in the municipality of Santos-SP (Brazil), the room temperature the was even lower (15 and 16.9 o C) than the recommendation in 43.3% of the cases, an aspect that may have contributed to the development of hypothermia.…”

“…Further investigations corroborated that room humidity did not interfere with hypothermia. 8,18 A study evaluating the variations of temperature and humidity of the operating room showed a statistically significant association between both. Thus, the lower the temperature of the room, the lower the humidity.…”