Operating Room Temperature Research Articles

The cold eye irrigation BSS solution used during phacoemulsification reduces post-surgery patients discomfort preventing the inflammation.

The aim of this study was to assess whether the intraoperative use of the cold eye irrigation balanced salt solution (BSS) could have a protective effect in preventing the anterior chamber flare and conjunctival hyperemia and, thus, in reducing patients discomfort after phacoemulsification. About 214 patients were enrolled and randomly divided into: patients whose eye were irrigated with BSS at ~ 20°C (Group 1) and patients whose eye were irrigated with BSS at 2.7°C (Group 2). Anterior chamber flare, visual analogue score and conjunctival hyperemia were evaluated at 1, 3, 5, and 30 days after surgery. In patients of Group 2 the anterior chamber flare, the visual analogue score and the conjunctival hyperemia, used as parameters to evaluated clinical inflammation, at 1 day after surgery were significantly lower than those in Group 1 who received BSS solution at operating room temperature (p < 0.001), while at day 3, 5, and 30 there were not any significant differences. Our study provided evidence supporting the efficacy of the treatment with cold irrigation solution on reduction of anterior chamber flare, pain and conjunctival hyperemia already at 1 day after phacoemulsification, suggesting that cooling procedure was fully effective at controlling early post-operative inflammation.

Intraoperative Temperature Monitoring with Zero Heat Flux Technology (3M SpotOn Sensor) in Comparison with Tympanic and Oesophageal Temperature and Hypotermia Risk Factors: An Observational Study.

ObjectiveInadvertent hypothermia (body temperature below 35°C) is a common and avoidable challenge during surgery under anaesthesia. It is related to coagulation (clotting) disorders, an increase in blood loss, and a higher rate of wound infection. One of the methods for non-invasive monitoring of the core body temperature is the 3M SpotOn zero heat flux method. In this approach, sensors placed at the frontal region of the patient measure the skin temperature by creating an isothermic channel. The study aimed to determine the risk factors for hypothermia and compare the 3M SpotOn zero heat flux method with the tympanic membrane (eardrum) and oesophageal (food pipe) temperature measurement methods.DesignObservational.Data sourcesThe patients’ data were collected, including age, gender, weight, BMI, other illnesses, smoking history, type of anaesthesia, duration of surgery, operating room temperature, pulse rate, blood pressure, blood loss, and transfusions. Body temperature was measured by the tympanic membrane method before and after surgery, oesophageal method during surgery, and SpotOn measurements throughout all three periods were recorded.Eligibility criteriaInclusion criteria was: adult patients, both genders, who had undergone major abdominal cancer surgery at the trialists’ institution, in whom the SpotOn zero heat flux, tympanic membrane, and oesophageal temperature measurement methods had all been used. Participant exclusion criteria was the absence of recorded data.ResultsIn this study, inadvertent intraoperative hypothermia incidence was 38.1% in the recovery room. Although gender, presence of comorbidities, history of smoking, administration of epidural anaesthesia, and requirement of blood transfusion [red blood cells (RBCs) and fresh frozen plasma (FFP)] did not affect hypothermia significantly during admission to the recovery room, prewarming the patient throughout the operation prevented the occurrence of hypothermia significantly (p=0.004). Additionally, as the American Society of Anaesthesiologists (ASA) physical status score worsened, the rate of hypothermia increased significantly (Frequency: 1st degree, 29.4%; 2nd degree, 47.5%; 3rd degree, 66.7%; X2Slope- p=0.047).ConclusionThe most significant risk factor was found to be not prewarming the patient as a strict procedure, and as the ASA physical status score worsened, the rate of hypothermia increased significantly. Besides, the SpotOn method provided temperature measurements as good as the oesophageal temperature measurements. Clinical Trial registration: ISRCTN 14027708.

Comparison of Combined Forced-Air Warming and Circulating-Water-Mattress and Forced-Air Warming Alone in Patients Undergoing Open Abdominal Surgery in Lithotomy Position: a Randomized Controlled Trial

The objective of this study was to evaluate the efficacy of warming devices in patients undergoing open abdominal surgery in lithotomy position. This randomized, controlled trial was designed to compare body temperatures of patients undergoing open abdominal surgery in lithotomy position between February and May 2019. After prewarming for 30 min with forced-air using a full-body blanket, patients were randomized to receive intraoperative warming either with forced-air using a blanket covering the upper torso and upper extremities in combination with circulating-water-mattress warming the back (Group I) or with only forced-air using blanket covering the upper torso and upper extremities (Group II). Primary outcome measure was the intraoperative change in core-body temperature using oesophageal temperature probe. A total of 28 patients were randomized. The mean core-body temperatures (Group I: 36.1 SD0.41 vs Group II: 35.9 SD0.53 °C; p=0.139) and intraoperative changes (Group I: 0.41% vs Group II: − 0.001%; p=0.306) were similar. The core-body temperature at the end of the operation correlated with the operating room temperature in Group II (r=0.862, p<0.001), but not in Group I (r=0.323, p=0.259). The combination of forced-air warming and circulating-water-mattress for open abdominal surgery in the lithotomy position may be more beneficial than forced-air warming alone, due to maintenance of the intraoperative mean core-body temperature ≥36°C, despite variations in operating room temperature. Trial Registry Number: ClinicalTrials.gov Identifier: NCT03824262 (Date of registry: 29 January 2019)

Assessment of intraoperative temperature management at the University Teaching Hospital of Kigali: A quality improvement project

Background: Due to the inhibition of thermoregulation by anesthetics, hypothermia occurs in 50% of patients undergoing general and neuraxial anesthesia without active warming. High-quality research has shown the negative effects of intraoperative hypothermia including increased rates of surgical site infections, increased hospital length of stay, increased cardiac morbidity and increased rate of transfusion. The University Teaching Hospital of Kigali commonly known as CHUK is the largest public referral hospital in Rwanda. The International Standards for Safe Anesthesia were not being met regarding intraoperative temperature management at CHUK. However, due to high ambient temperature in the operating room, it was unknown if this was a significant problem and worth investment, in a health system, with limited resources. Methods: After institutional review board approval, a two-stage descriptive cross-sectional quality improvement project was performed. The first stage was to assess current management of intra-operative temperature, determine if there was a significant rate of hypothermia and establish risk factors for developing intra-operative hypothermia in this clinical setting. The second stage was to determine if locally available warming techniques, an underbody warming blanket, significantly reduced the incidence of intra-operative hypothermia. Results: The primary result of the study was a 58% incidence of hypothermia with current standard practice. This was reduced to 6% with the use of an underbody water blanket. Temperature was measure intraoperatively in only 6% of cases and never documented. Adult patients and patients undergoing neuraxial anesthesia were more likely to experience hypothermia. Conclusions: Intraoperative hypothermia is common at CHUK despite high ambient operating room temperature. Monitoring and documentation of temperature is not occurring on a regular basis. The use of underbody water body, though not the gold standard for intraoperative warming, was effective in this study and a realistic solution in an environment with limited resources.

Evaluation of the difficulty of peripheral venous cannulation during anesthesia induction in children: Is DIVA score sufficient?

The primary objective of the present study was to determine the rate and the independent predictors of the difficult peripheral intravascular access (PIVA) in the operating room (OR). The secondary objective was to validate the ability of the difficult intravenous access (DIVA) scoring system in the detection of difficult PIVA in the operating room. In this prospective observational study, patients between 0 and 18 years old who were operated in the pediatric hospital were evaluated. Peripheral intravenous cannulation performed during inhalation induction in 1008 patients were recorded. The following data were collected: demographic characteristics, the presence of a chronic disease, the DIVA score, operating room temperature, the area of PIVA application, the duration of PIVA and the number of PIVA attempts. The independent determinants of the difficult PIVA were determined with multivariate logistic regression. A total of 1008 patients (82% boys) with a median age of 4 (range 0.04-17 years) were included in the study. The median number of PIVA attempts was 1 whereas the median duration for successful PIVA was 15 s (range 4-2100). PIVA was successful at the first attempt in 75.3% of patients. Among patients who required more than two PIVA attempts, the most common adjunctive method was to seek help from another operator (80.8%). In the multivariable logistic regression model, only the presence of chronic disease, being underweight, and DIVA score ⩾4 (OR 6.355, CI 4.57-9.486) remained to be the significant determinants of difficult PIVA. The success rate of anesthesiologist-performed PIVA at the first attempt in the OR was 75.3%. Having a chronic disease, a DIVA score ⩾4 and being underweight appeared as the independent predictors for difficult PIVA.

Effect of amino acid infusion on perioperative thermoregulation in newborn surgery

Objectives: Decreased drug metabolism, coagulation disorders, wound infections, and cardiac arrhythmias are the most important and well-known results of intraoperative hypothermia. Perioperative amino acid infusion is known to prevent intraoperative hypothermia during general anesthesia in adults. In this study, we aimed to demonstrate the effect of perioperative amino acid infusion on the prevention of hypothermia during general anesthesia in newborn surgery. Methods: Twenty surgical newborns, aged 1-30 days, were enrolled in this prospective randomized controlled study. Newborns were assigned randomly into two groups: the amino acid/dextrose (AAD) group and the dextrose (D) group. The core temperatures of the newborns were measured from the distal esophagus in the first minute of the induction once and every fifteen minutes thereafter. The core body temperature changes in each group during the operation and the differences between the two groups were analyzed. Results: The surgical operations in each group were similar. The mean operating room temperatures of AAD and D groups were 25.4 ± 0.2°C and 25.3 ± 0.3°C, respectively. There were no significant differences in the general characteristics of the two groups. The mean core temperatures began to decrease after the induction of anesthesia in both groups and continued to decrease during the course of the surgery. There was no significant difference between the two groups. Conclusions: Hypothermia develops in all neonates when surgical time exceeds one hour, even in warmer ambient temperatures. Although it seems effective in adults, amino acid-induced thermoregulation does not seem effective in newborns during general anesthesia.

The Clinical Impact of Ambient Operating Room Temperature and Other Perioperative Factors on Patient Comfort during Wide-awake Hand Surgery Using Local Anesthesia.

The prevalence of wide-awake hand surgery using local anesthesia has increased substantially. The full influence of perioperative factors, namely operating room temperature, on patient comfort during these procedures is presently underreported. One hundred and fifty-eight patients undergoing wide-awake hand surgery using local anesthesia were prospectively enrolled. Surveys with visual analog scale (VAS) were administered after surgery to assess overall patient comfort (OPC) and patient comfort with temperature (TPC). Operating room temperature at the initiation of the procedure, surgery type, duration of surgery, tourniquet use and local anesthetic use were all recorded and their impact on patient comfort analyzed. The VAS used ranged from 1 (least comfortable) to 5 (most comfortable). Across all patients, the mean OPC was 4.7 (Range: 2 - 5, SD=0.6) and the mean TPC score was 4.7 (Range 2 - 5, SD=0.6). There were weakly negative correlations between room temperature and VAS score for OPC (rs =-0.2, p =.038) and TPC (rs=-0.2, p =.051). The mean OPC score was lower with tourniquet use [4.6 (SD=0.7) versus 4.9 (SD=0.4), p =.002]. Patient comfort during surgery using local anesthesia is not substantially affected by operating room temperature. Tourniquet use negatively impacts patient-reported comfort. Continued studies into the optimization of patient comfort during wide-awake hand surgery are warranted.

Retrograd İntrarenal Cerrahi Esnasında Oluşan Vücut Sıcaklık Değişikliklerini Etkileyen Faktörler

Objectives : When compared to other endourologic operations, irrigation fluid with lower flow rate and volume is used during retrograde intrarenal surgery (RIRS). In our study, body temperature changes occurring due to irrigation fluid and factors affecting these were assessed. Materials and Methods: One hundred and twenty-eight patients were prospectively included in the study. During operations, a standart izotonic irrigation fluid kept in the operating room at 21 °C was used. Active heating was not applied to any patient. Body temperature of patients was measured peripherally before anesthesia induction and before recovery. Relationship of body temperature differences with patient characteristics, operation time, irrigation fluid volüme and stone size was evaluated. Results : Mean tympanic body temperature was 36,3±0,35°C at the start of operation and 35,8±0,5°C at the end. Post-operative fall in body temperature (0,67±0,47°C) was recorded in 102 patients (79.7%). When body tempertaure values before and after the operation were compared, a significant reduction was found (p<0,0001). No statistically significant correlation was obtained between this reduction and patient and operative data. Conclusion : Body temperature falls after RIRC however, no relation was found between temperature change and patient and operative data other than operating room temperature.

Effectiveness of Dexamethasone for Prevention of Intraoperative Shivering in Caesarean Delivery Under Subarachnoid Block

Introduction: Shivering is frequently seen after subarachnoid block. Subarachnoid block impairs the thermoregulation system by inhibiting tonic vasoconstriction with redistribution of blood flow and core heat from the trunk to the peripheral tissue. Intraoperative shivering leads to increase in oxygen consumption and carbon dioxide production. This causes an increase in heart rate, blood pressure resulting in exacerbation of ischemic heart disease, increased risk of hypoxemia, intraocular pressure, intracranial pressure, metabolic rate, lactic acidosis, pain at the surgical site and discomfort to the patient.&#x0D; Objective: To assess the effectiveness of Dexamethasone in preventing intraoperative shivering in patients of cesarean delivery under subarachnoid block.&#x0D; Methodology: This was a hospital based prospective, comparative, cross sectional study which was conducted from February 2019 to July 2019 among 88 pregnant patients of age group 18 to 35 years old, American Society of Anesthesiologists (ASA) physical status 1 and 2, posted for elective or emergency caesarean delivery at Birat Medical College and Teaching Hospital (BMCTH). Operation room temperature was recorded by a wall thermometer and maintained during surgery between 20 to 25 degree Celsius and intravenous fluids were kept at this temperature. Patients were divided into two equal groups. Group S (study group) patients received 2 ml or 8mg of dexamethasone IV (As a premedication before giving subarachnoid block) while group C (control group) patients received 2 ml of normal saline. If the patients shivered according to classification of shivering, the prophylaxis was regarded as ineffective.&#x0D; Results: Patients undergoing caesarean delivery under subarachnoid block had significantly reduced (p value = 0.002) intraopera tive shivering who received prophylactic dexamethasone (group S).&#x0D; Conclusion: The prophylactic use of 8mg i.v dexamethasone was significant in prevention of shivering in Nepalese population who underwent caesarean delivery under subarachnoid block.

Numerical investigations of temperature and hemodynamics in carotid arteries with and without atherosclerotic plaque during open surgery.

Intraoperative monitoring is essential for providing safe and effective care during open surgery. In this paper, numerical simulation is performed to track the flow and heat transfer of carotid arteries with and without atherosclerotic plaque in a real physiological system during surgery, in which the heat transport is first considered to couple to the blood flow due to the temperature dependence of the blood viscosity. The impacts of the operating room temperature and hematocrit (H) on the viscosity, velocity, temperature, wall shear stress (WSS), pressure drop and oscillation are investigated. The results demonstrate that the presence of plaque in the carotid artery induces a greater blood flow velocity, pressure drop, WSS, and oscillation, as well as a smaller viscosity and temperature variations. A decreasing ambient temperature leads to a decrease in the temperature and an increase in the low-WSS area, which implies a greater risk of hypothermia and atherosclerosis. As H increases, the high-WSS areas substantially expand; when H varies from 65% to 80%, WSSave increases by 70.02% and 68.57% for the arteries with and without plaque, respectively, which indicates a higher risk of vascular injury. The results obtained can serve as a guideline regarding the selection of an operating room temperature for carotid disease patients with distinct hematocrits.

Management of Pain During Propofol Injection Using Intravenous Nitroglycerine

Background: Propofol is an intravenous (IV) anesthetic agent, can irritate the skin, mucous membrane and venous intima. The main drawback is the pain at injection site following its intravenous injection.&#x0D; Objectives: This study was performed to evaluate the effect of intravenous nitroglycerine on pain in patients following propofol injection.&#x0D; Materials and Methods: Eighty adult patients of both sexes, aged 20-50 years, according to American Society of Anesthesiologists (ASA) physical status were divided into two equal groups (n=40) to receive 200 mcg intravenous nitroglycerine diluted in 10 ml saline (group A) and 10 ml normal saline as placebo (group B) at an ambient operating room temperature in a randomized and double blinded fashion to compare the pain-relieving effects of the drugs during propofol injection before the patients lost consciousness. The pain on propofol injection was assessed according to the Mc Crirrick and Hunter scale.&#x0D; Results: The overall incidence and severity of pain were significantly less in Groups A (nitroglycerine group) than group B (placebo group) (p&lt; 0.05). The incidence of mild and moderate pain in Group A versus group B was 25% vs 45% and 15% vs 30% respectively (p&lt;0.05). The incidence of score '0' (no pain) was higher in Group A (60%) than Group B (25%) (p&lt;0.05).&#x0D; Conclusion: Pretreatment with 200 mcg nitroglycerine with venous occlusion for one minute is effective pretreatment in alleviating propofol injection pain when compared to placebo.&#x0D; KYAMC Journal Vol. 10, No.-4, January 2020, Page 202-205

Open sternum, cooler heart: The effect of surgical approach on myocardial temperature.

We previously demonstrated del Nido solution to be a safe alternative to conventional cardioplegia in adult isolated valve surgery; however, there is little information concerning factors that might influence its effectiveness.1 Because the heart is directly exposed to a number of factors influencing temperature (eg, operative lights, ambient operating room temperature of 19°C) in a sternotomy and a robotic procedure, the heart remains predominately enclosed in the body cavity (with, perhaps, a lesser potential for radiant heat loss), we hypothesized that myocardial temperature may differ during mitral surgery performed through these approaches.

Risk factors for early flap misalignment following microkeratome-assisted laser in situ keratomileusis: A retrospective large database analysis.

To determine factors associated with early flap misalignment following microkeratome-assisted laser in situ keratomileusis. This retrospective study included the right eyes of consecutive patients who underwent laser in situ keratomileusis procedure between 2005 and 2016 at Care-Vision Laser Centers, Tel-Aviv, Israel. Patients were divided into two groups according to whether or not they subsequently developed early flap misalignment. A total of 14,582 eyes (mean age of patients: 32.4 ± 10.3 years) were included. Post-laser in situ keratomileusis early flap misalignment developed in 158 eyes (1.1%). Misalignment was more frequent during the spring (32.3% vs 22.8%, p = 0.003) and in a higher operating room temperature (23.34 ± 1.06 vs 22.98 ± 1.26, p < 0.001). In addition, in the misalignment group, there was a higher rate with the of use of the a Moria M2 microkeratome (rather than sub-Bowman's keratomileusis microkeratome) head (55.2% vs 40.5%, respectively, p < 0.001). In a multivariable analysis adjusted for surgeon and year of surgery, high operating room temperature (odds ratio = 1.22, p = 0.006), treatment zone of 9.0 mm (as opposed to smaller treatment zones, odds ratio = 1.54, p = 0.04), and springtime (odds ratio = 1.58, p = 0.02) were associated with flap misalignment. There was a significant difference in misalignment rates between surgeons (p = 0.02). This study found that larger treatment zones, higher operating room temperature, operating during the spring, and the use of Moria M2 microkeratome were associated with increased flap misalignment rates. The association with operating room temperature and seasonal variation is of interest and merits further research.

Perioperative temperature management in adult anesthesia

Body temperature management is very important to be controlled in surgery because there are so many effects that can be caused due to uncontrolled body temperature during operations such as decreased heart rate, breathing frequency and blood pressure, the skin becomes cyanotic, and even can cause disturbance of consciousness. The body already has a mechanism that can reduce the risk of a decrease in temperature during surgery such as skin vasoconstriction, changes in behavior, shivering and non-shivering thermogenesis. Many factors can influence changes in body temperature thermoregulation in the operating room such as operating room temperature, area of surgery wound, fluid, age, anesthesia, and the duration of the operation, so that we need to know perioperative temperature management.

Comparison of temporal artery temperature and bladder temperature in the postanesthesia care unit

To verify that temporal artery (TA) temperature measured in the postanesthesia care unit (PACU) in noncardiac surgical patients is a valid reflection of core temperature, a prospective, observational, institutional review board–approved study was conducted in a large, academic tertiary care hospital. The study developed from an initial quality improvement project. A total of 276 patients who had an indwelling bladder catheter as standard of care were enrolled when a research student was available over a 6-month period in 2015. Infrared TA temperature was measured (average of three readings) simultaneously with bladder temperature on PACU arrival. Mean temperature in the bladder and TA groups was >36°C with a clinically negligible difference (0.125°C; 90% confidence interval, 0.059–0.192). Agreement between bladder and TA temperatures, as well as between bladder and last operating room temperatures, was >95% by Bland-Altman analysis. A properly performed TA temperature measure on PACU arrival is an acceptable representation of core temperature for purposes of quality assessment, patient comfort, and regulatory requirements.

Bias-Controlled Tunable Electronic Transport with Memory Characteristics in an Individual ZnO Nanowire for Realization of a Self-Driven UV Photodetector with Two Symmetrical Electrodes.

ZnO nanostructures are exceedingly important building blocks for nanodevices due to their wide band gap and large exciton binding energy. However, their electronic transport characteristics are unstable and unrepeatable with external environment variation. Here, we demonstrate that electron transport of an individual ZnO nanowire-based device with the two same electrodes can be controllably modulated by applying a relatively large uni-/bidirectional bias. After being modulated, moreover, their electrical properties can well be maintained at relatively low operation bias and room temperature, demonstrating a memory behavior. The presence of surface states related to lattice periodicity breaking and traps associated with oxygen vacancy (Vo) and zinc interstitial (Zni) deep-level defects plays a crucial role in tunable electron transport with a memory feature. For the single nanowire-based two-terminal device, two back-to-back connected surface barrier diodes with series resistance are formed. The filling and emptying of traps near two end electrodes can remarkably adjust the width and height of the surface barrier. At a relatively low bias, the unmodulated conductance is governed by the electron hopping of bulk traps since the height of emptied traps is higher than that of the surface barrier, whereas at a relatively large bias, it is dominated by thermion emission due to a dramatic decrease of the surface barrier width resulting from the electron injection into traps from a negative electrode. Moreover, it will be beneficial for a thin surface barrier to penetrate UV light and separate photoexcited electron-hole pairs. After being asymmetrically modulated by a unidirectional injection, it can be successfully applied to realize a self-driven UV photodetector based on a photovoltaic effect in the symmetrical two-electrode structure. Our work provides a new route to tune electrical properties of nanostructures, which may inspire the development of novel electronic and optoelectronic devices.

Significant factors influencing inadvertent hypothermia in pediatric anesthesia.

Thermal imbalances are very common during surgery. Hypothermia exposes the patient to post-operative shivering, cardiac dysfunction, coagulopathy, bleeding, wound infection, delayed anesthesia recovery, prolonged hospital stay and increased hospitalization cost. There are many factors contributing to intraoperative hypothermia. This is a prospective cohort study conducted through observation and measurement of pediatric surgical patients' temperature. Convenience sampling methods were used in this study. Initial skin temperature and core temperature at 10min, 30min,1h, 2h, 3h, 4h, 5h, 6h and at the end of surgery were recorded. Body temperature was monitored from time of transfer to the operating table until recovery and discharge to the respective pediatric ward. The overall incidence of intraoperative hypothermia was still very high at about 46.6% even though active and passive temperature management were carried out during surgery. Patient's age, body weight, duration of surgery, type of surgery, intraoperative blood loss, type of anesthesia and operating room temperature were factors that contributed to intraoperative hypothermia. Hypothermia is common in surgery, especially in major and long duration surgery. Intraoperative hypothermia can be life threatening if it is not handled carefully. Various methods are used before, during and after surgery to maintain a patient's body temperature within the normothermia range. The use of an active warming device like the Bair Hugger® air-forced warming system seems to be a good method for reducing the risk of intraoperative hypothermia and effectively maintaining body temperature for all major and minor surgeries.

Magnitude and associated factors of Perioperative hypothermia in patients who underwent Elective surgery at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.

Background : Body temperature is a vital sign and 37°C is the mean core body temperature of a healthy human. Core body temperature is normally tightly regulated and maintained within narrow range. Perioperative hypothermia is one of the major problems during surgery and anesthesia that can affect operated patients. Methods: Institutional based cross-sectional study was conducted. Patient interview, chart review and temperature measurement were employed for data collection. Temperature was measured using tympanic membrane thermometer. SPSS version 20 software was used for analysis. binary logistic regression was used to look at associations anda p-value of &lt;0.05 was considered statistically significant.&#x0D; Result :The overall magnitude of preoperative, intra and post-operative hypothermia in this study was 16.2%, 53.2% and 31.3%, respectively. Age (AOR=7.15, 95% CI, 1.16, 43.99), coexisting illness (AOR, 3.32, 95% CI, 1.06; 10.36), preoperative hypothermia (AOR; 57; 95% CI; 7.1, 455.4), operation room temperature (AOR=1.91; 95 % CI, 1.04; 3.5) and crystalloid fluids administered (AOR; 2.3; 95% CI, 1.07, 4.9) were found to be factors associated with intraoperative hypothermia.&#x0D; Conclusion and recommendation: The magnitude of perioperative hypothermia remains high. Measures should focus on improving room temperature and warming up fluids. Susceptible patients like the aged and those with coexisting disease should be given extra attention.&#x0D;

Intraoperative optical pachymetry in photorefractive keratectomy

Tostudy the effect of variables on the accuracy and reliability of the optical pachymeter built into the WaveLight EX500 excimer laser during photorefractive keratectomy (PRK). John A. Moran Eye Center, University of Utah, Salt Lake City, USA. Retrospective case series. A chart review of 352 eyes (181 patients) that had excimer laser PRK was performed. Programmed excimer laser residual stromal bed (RSB) measurements, optical pachymeter measurements after ablation, and Scheimpflug pachymetry measurements (Pentacam) at the 1-year follow-up were compared. Variables included ablation time, preoperative spherical equivalent (SE), 1-year SE, mitomycin-C use, operating room temperature and humidity, and programmed monovision. The mean programmed RSB was 27μm greater than the optical pachymetry post-ablation measurement (P<.001). Of patients with a 1-year follow-up, the 1-year Scheimpflug pachymetry RSB was 24μm greater than the optical pachymetry post-ablation RSB (P<.001). Comparison of the programmed RSB with the optical pachymetry post-ablation RSB showed that the preoperative SE and ablation time had a Pearson correlation coefficient of -0.36 and 0.30, respectively (P<.001). There was no correlation between operating room temperature, humidity, or programmed monovision with these differences. The RSB post-ablation values measured by optical pachymetry during PRK were significantly lower than the programmed excimer laser RSB value and 1-year Scheimpflug pachymetry RSB value. Intraoperative pachymetry during PRK underpredicted the actual long-term RSB thickness. The greater temporary drying effect associated with increased ablation time in higher myopic corrections might have caused this error.

51: The effect of operating room temperature on neonatal morbidity and mortality: a cluster- randomized trial

51: The effect of operating room temperature on neonatal morbidity and mortality: a cluster- randomized trial