Impact of the Hormonal Status in Women on Intraoperative Hypothermia during Laparoscopic Gynecologic Surgery when Considering the Fresh Gas Flow Rate: A Retrospective Study.

Cheol Lee,Juhwan Lee,Hyungtae Kim,Seongnam Park,Myeongjong Lee,Gongheui Lee

doi:10.1155/2022/5305165

Abstract

Previous studies reported the impact of intrinsic and extrinsic factors on intraoperative hypothermia. However, no clinical study to date has considered the effects of both the phase of the menstrual cycle (an intrinsic factor) and the fresh gas flow rate (FGF) during anesthesia (an extrinsic factor) on the core body temperature and intraoperative hypothermia. This study is aimed at investigatig the effect of the menstrual cycle phase on intraoperative hypothermia when considering the FGF in patients who underwent laparoscopic gynecologic surgery. This study included 667 women aged 19-65 years with menstruation cycles and menopause. The patients were divided into the follicular, luteal, and menopause groups. The primary outcome was the correlations of hormonal status with intraoperative hypothermia. Secondary outcomes included the incidence of intraoperative hypothermia, time to onset of hypothermia, incidence of shivering after anesthesia, and frequency of antishivering drug use in the three groups and risk factors for hypothermia. Overall, the hypothermia incidence was the lowest and the time to onset of hypothermia was the longest in the luteal phase group. At a high FGF, the incidence of hypothermia in the luteal phase group was lower than that in the other two groups (P < 0.05). At a low FGF, the time to onset of hypothermia in the luteal phase group was longer than that in the other two groups (P < 0.05). The female hormonal status had weak positive correlations with hypothermia at low and high FGF rates. A high FGF in univariate and multivariate analyses, follicular phase and menopause in multivariate analysis, and estradiol and progesterone levels in univariate analysis were risk factors for hypothermia. When considering the FGF, the luteal phase is associated with better outcomes concerning intraoperative hypothermia.

Highlights

Intraoperative hypothermia is defined as a core body temperature of less than 36°C in patients undergoing anesthesia and surgery [1,2,3,4,5,6]
Core body temperature before anesthesia induction and nasopharyngeal body temperature during anesthesia reversal were significantly higher in the luteal group than in the other two groups (P ≤ 0:01)
The incidence of hypothermia during surgery was lower, and the time to onset of hypothermia was longer in the luteal phase group than in the other two groups (P ≤ 0:01) (Table 1)

Summary

Introduction

Intraoperative hypothermia is defined as a core body temperature of less than 36°C in patients undergoing anesthesia and surgery [1,2,3,4,5,6]. The adverse effects and complications of intraoperative hypothermia include cardiac arrhythmia, wound infection, postoperative pain, shivering, metabolic disturbances, and prolonged hospitalization [1,2,3,4,5,6]. BioMed Research International hypothermia include age, sex, smoking, ASA scores, operating room temperature, BMI, preoperative body temperature, type of anesthesia, duration of anesthesia and operation, FGF, and hemodynamic status [2, 6]. There is no strong evidence to identify a single independent variable as a factor that increases the risk of intraoperative hypothermia

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Results