Incidence and risk factors of perioperative hypothermia in adults undergoing cancer surgery- A quality improvement audit

Anaesthesia (either general or neuraxial) is known to impair the thermoregulatory mechanisms that maintain the body temperature. As a result of this anaesthetised patients who are not warmed can become hypothermic with a temperature drop of 1- 2 °C. Hypothermia is defined as core body temperature < 36 ̊C. Hypothermia causes many pathophysiological changes like respiratory depression due to altered drug metabolism, increased oxygen demands, arrhythmias, myocardial ischaemia, tissue hypoxia, metabolic acidosis, and coagulopathy.Hypothermia is a silent and often missed factor with adverse post operative out- comes like delayed recovery, adverse cardiac events, increased risk of wound infection, delay in surgical site wound healing, increased transfusion requirements, patient discomfort due to shivering, prolonged ICU or hospital stay. Hence it is very important to maintain normothermia during the perioperative period.This study therefore aims to analyse incidence of perioperative hypothermia in cancer surgeries along with its risk factors and adverse effects like intra-operative arrhythmia, blood loss, delayed recovery from anaesthesia or neuromuscular blockade, unplanned post op ventilator support, post-op shivering, surgical site infection, prolonged ICU stay, prolonged hospital stay. We will also see if there are any complications like hyperthermia and thermal injury due to the warming measures.The results of this quality improvement audit would help in developing institution specific protocols for preventing perioperative hypothermia and improving patient care.