The Sweaty Surgeon: Raising Ambient Operating Room Temperature Benefits Neither Patient nor Surgeon

An Experimental Simulation of Heat Effects on Cognition and Workload of Surgical Team Members

“…Heating operating rooms risks increased subjective workload, in addition to impaired cognitive speed and accuracy. 7,21,23 This study aimed to investigate the impact of heat exposure during surgery on cognitive functioning and subjective workload. Because prior research suggests that activity levels can compound the effects of heat, we additionally considered this factor.…”

“…Heat can increase negative affect and subjective discomfort, 11 and increase perceptions of surgery workload 11,18 Physician burnout is pervasive, caused in part by the human “cost” incurred when implementing practices during surgical procedures that are known to benefit patients, but may increase effort for surgical teams. Heating operating rooms risks increased subjective workload, in addition to impaired cognitive speed and accuracy 7,11,21 …”

Letter to the Editor on “Hypothermia in Total Joint Arthroplasty: A Wake-Up Call”

“…We initiated our project after concerns that forced air warmers may interfere with room air flow [2], and after reading the Journal of Arthroplasty study showing noninferiority of reflective blankets compared with a forced air system [3]. We were further concerned that elevating the ambient OR temperature would be uncomfortable for the surgical team and may lead to a "distracted surgeon" and patient safety issues [4]. Moreover, we noted that OR room temperature and patient temperature are not well correlated [5].…”

“…In landmark studies by Morris and Wilkey [2,3], the recommended ambient operating room temperature was 21 C (69 F) to maintain a core body temperature greater than 36 C (96.8 F) in the paralyzed, anesthetized patient. An updated evaluation on ambient room temperature by Wang et al [4] found increasing the ambient room temperature from 21 C (69 F) to 24 C (75 F) in hepatic surgery raised the core body temperature 0.5 C maintaining normothermia. Evidenced-based reviews by the American Society of Perioperative Nursing (ASPAN) [5], the American Society for Healthcare Engineers [6], and the Canadian Association of General Surgeons [7] recommend maintaining an ambient room temperature of greater than 21 C (69 F) to prevent intraoperative hypothermia.…”