Perioperatif istemsiz hipotermi postoperatif bulantı ve kusma varlığını etkiler mi? Bir literatür incelemesi

Yıl 2021, Cilt: 14 Sayı: 3, 594 - 605, 15.12.2021

Özlem Şahin Akboğa

https://doi.org/10.26559/mersinsbd.842574

Öz

Ameliyat döneminde hipotermi, ameliyat öncesi dönemden (anestezi öncesi bir saat), ameliyat sonrası döneme (anestezi sonrası ilk 24 saat) kadar geçen süre içinde vücut sıcaklığının 36°C’nin altına düşmesi olarak tanımlanmaktadır. Ameliyat olması gereken veya ameliyat olan tüm hastalar, yaygın olarak ameliyat boyunca hipotermiye girme riski altındadır. Cerrahi geçiren hastalarda sadece ameliyat sonrası dönemde hipotermi, %26 ila %90 arasında görüldüğü bildirilmektedir. Görülme oranı oldukça yüksek olan hipotermi, istenmeyen bir durumdur. Çünkü, istenmeyen hipotermi, hastanın ısı konforsuzluğundan morbidite ve mortalite artışına kadar varan ciddi olumsuz sonuçlara neden olmaktadır. Özellikle erken dönemde, titreme, titreme ile birlikte oksijen tüketiminde artma, termal konforda bozulma, uzun süreli anestezik ilacın etkisinde kalma, dolayısıyla ayılma ünitesinde kalış süresinde uzama, koagülopati, kan tranfüzyonu ihtiyacında artma, insülin ve kortizol seviyesinde yükselme, ameliyat sonrası bulantı-kusma insidansında artış bu olumsuz sonuçlar arasında yer almaktadır. İstenmeyen hipotermi ve bu komplikasyonlar ile ilişkisi hakkında pek çok çalışma yapılmasına rağmen, bulantı kusma ile ilişkisi hakkında çok az çalışmaya rastlanmıştır. Bu sistematik incelemede, istenmeyen hipotermi gelişen hastalarda hipoterminin ameliyat sonrası görülen bulantı-kusma üzerine etkisi ile ilgili yapılan araştırmaların gözden geçirilmesi ve çalışmalardan elde edilen verilerin değerlendirilmesi amaçlanmıştır. Yapılan literatür taraması sonucunda istenmeyen hipotermiyi önlemeye yönelik pek çok uygulamanın olduğu belirlenmiştir. Çalışmamızda, yapılan uygulamalar sonrası bulantı kusmanın değerlendirildiği çalışmalar derlenmiştir. Ulaşılan kaynaklarda istenmeyen hipotermiyi önlemeye yönelik yapılan uygulamaların, bulantı kusmanın azaltılması üzerine olumlu etkileri olduğu bildirilmiştir.

Anahtar Kelimeler

hipotermi, ameliyat sonrası bulantı, kusma

Teşekkür

Şimdiden emeğinizi teşekkür ederim.

Does ınadverdent perioperative hypothermia affect postoperative nausea and vomiting? A literature review

Öz

Hypothermia during surgery is defined as a decrease in body temperature below 36°C during the period from the preoperative period (1 hour before anesthesia) to the postoperative period (the first 24 hours after anesthesia). All patients who require surgery are or having surgery at risk of hypothermia throughout surgery commonly. Only in the postoperative period hypothermia is reported to occur in 26% to 90% of patients undergoing surgery. Hypothermia, whose incidence is quite high, is an undesirable case. Because inadverdent hypothermia causes serious negative consequences, ranging from the patient’s lack of heat comfort to an increase in morbidity and mortality. Especially in the early period, tremors, tremor with the increase in oxygen consumption, thermal comfort impairment of long-term remain under the influence of anesthetic drugs, hence waking elongation per unit time, coagulopathy, increase of blood transfusion need increase of insulin and cortisol levels, post-operative nausea and vomiting are among the negative results that increase in symptoms. Although many studies have been conducted on the association of inadverdent hypothermia with these complications, few studies have been found on the association of nausea with vomiting. In this systematic review, it was aimed to review the effects of post-operative nausea on vomiting in patients who develop inadverdent hypothermia and to evaluate the data obtained from the studies. As a result of the literature review, there are many applications to prevent inadverdent hypothermia. In our study, studies in which nausea and vomiting were evaluated after certain procedures were compiled. It has been reported that these procedures to prevent inadverdent hypothermia have positive effects on nausea and vomiting.

Anahtar Kelimeler

Hypothermia, postoperative nausea, vomiting

Kaynakça

• 1. National Institute for Health and Clinical Excellence 2019, Erişim Yeri: https://pathways.nice.org.uk/pathways/inadvertent-perioperative-hypothermia Erişim Tarihi:13.01.2020.
• 2. Association of Operation Room Nurses 2019, Erişim Yeri: https://www.aorn.org/guidelines/about-aorn-guidelines/evidence-tables, Erişim Tarihi:13.01.2020.
• 3. Hooper VD, Chard R, Clifford T, Fetzer S, Fossum S, Godden B, & Peterson C. ASPAN's evidence-based clinical practice guideline for the promotion of perioperative normothermia. Journal of perianesthesia nursing, 2009; 24(5); 271-287.
• 4. Association of Surgical Technologist (AST). AST standards of practice for maintenance of normothermia in the perioperative patient 2015, Erişim Yeri: http://www.ast.org/uploadedFiles/Main_Site/Content/About_Us/SOP_For_Normothermia.pdf. Erişim Tarihi:13.01.2020.
• 5. Giuliano KK, Hendricks J. Inadvertent perioperative hypothermia: current nursing knowledge.AORN Journal, 2017; 105(5): 453-463.
• 6. Türk Anestezi ve Reanimasyon Derneği (TARD). Anesthesıa Applıcatıon Guıdelınes: Guıdelınes preventıon unwanted perıoperatıve hypothermy. Turk J Anaesth Reanim, 2013; 41:188-90.
• 7. Soysal GE, İlçe A. Ameliyat Döneminde İstenmeyen Hipotermide Kanıta Dayalı Uygulamalar. Bozok Tıp Dergisi, 2018; 8(2): 72-79.
• 8. Bilgin H. Inadverdent perioperative hypothermia. Turkish Journal of Anaesthesiology and Reanimation, 2017;45(3):124.
• 9. Simpson JB, Thomas VS, Ismaily S K, Muradov PI, Noble PC, & Incavo SJ. Hypothermia in total joint arthroplasty: A wake-up call. The Journal of arthroplasty, 2018;33(4):1012-1018.
• 10. Putnam K. Prevention of unplanned patient hypothermia. AORN Inc. 2015;104(2):10-2.
• 11. Alderson P, Campbell G, Smith AF, Warttig S, Nicholson A, & Lewis SR. Thermal insulation for preventing inadvertent perioperative hypothermia. Cochrane Database of Systematic Reviews, 2014; (6); 6:CD009908
• 12. Xiong J, Kurz A, Sessler DI, Plattner O, Christensen R, Dechert M, & Ikeda T. Isoflurane produces marked and nonlinear decreases in the vasoconstriction and shivering thresholds. Anesthesiology: The Journal of the American Society of Anesthesiologists, 1996; 85(2): 240-245.
• 13. Guyton AC, Hall JE. Guyton ve Hall tıbbi fizyoloji. Güneş Tıp Kitabevleri. 13. baskı. 2017: 911-919. Ankara.
• 14. Bajwa SJS, Swati MD. Perioperative hypothermia in pediatric patients: diagnosis, prevention and management. Anaesthesia, Pain & Intensive Care, 2019: 274-278.
• 15. Coello PA, Gatell RJ, Rodriguez FG, Garcia LM, Orrego C, & Comas DR. Clinical practice quideline for the patients safety at surgery setting. Ministry of Science and Innovation. 2010. Erişim yeri: http://www.guiasalud.es/GPC/GPC_478_Seguridad_Paciente_AIAQS_compl_en.pdf. Erişim Tarihi: 14.02.2020.
• 16. Aydın H, Şimşek T, Demiraran Y. Effects of Inadvertent Perioperative Hypothermia on Metabolic and Inflammatory Mediators. Turkish Journal of Anaesthesiology and Reanimation, 2019;47(6):448. doi: 10.5152/TJAR.2019.94715.
• 17. Su SF, Nieh HC. Efficacy of forced‐air warming for preventing perioperative hypothermia and related complications in patients undergoing laparoscopic surgery: A randomized controlled trial. International Journal of Nursing Practice, 2018;24(5):e12660. doi: 10.1111/ijn.12660.
• 18. Choi JW, Kim DK, Lee SW, Park JB, Lee GH. Efficacy of intravenous fluid warming during goal-directed fluid therapy in patients undergoing laparoscopic colorectal surgery: a randomized controlled trial. Journal of International Medical Research, 2016; 44(3):605-612.doi: 10.1177/0300060516638991.
• 19. Smith ND, Abernethy C, Allgar V, Foster L, Martinson V, Stones E. An open label, randomised controlled trial on the effectiveness of the Orve+ Wrap® versus forced air warming in restoring normothermia in the post anaesthetic care unit. J Clin Nurs, 2019;31. doi: 10.1111/jocn.15159.
• 20. Yi J, Lei Y, Xu S, Si Y, Li S, Xia Z... & Gu E. Intraoperative hypothermia and its clinical outcomes in patients undergoing general anesthesia: National study in China. PloS one, 2017; 12(6), e0177221. doi: 10.1371/journal.pone.0177221.
• 21. Santa Maria P L, Santa Maria C, Eisenried A, Velasquez N, Kannard, BT, Ramani A, & Brock-Utne J G. A novel thermal compression device for perioperative warming: A randomized trial for feasibility and efficacy. BMC anesthesiology, 2017;17(1), 102. doi: 10.1186/s12871-017-0395-2.
• 22. Chebbout R, Newton RS, Walters M, Wrench IJ, Woolnough M. Does the addition of active body warming to in-line intravenous fluid warming prevent maternal hypothermia during elective caesarean section? A randomised controlled trial. Int J. Obstet Anesthology, 2017;31:37-44. doi: 10.1016/j.ijoa.2017.04.008.
• 23. Benson EE, McMillan D E, Ong B. The effects of active warming on patient temperature and pain after total knee arthroplasty. AJN The American Journal of Nursing, 2012; 112(5):26-33. doi: 10.1097/01.NAJ.0000414315.41460.bf.
• 24. Pan X, Ye L, Liu Z, Wen H, Hu Y, Xu X. Effect of irrigation fluid temperature on core body temperature and inflammatory response during arthroscopic shoulder surgery. Archives of Orthopaedic and Trauma Surgery, 2015; 135(8): 1131-1139.
• 25. Granum MN, Kaasby K, Skou ST, Grønkjær M. Preventing inadvertent hypothermia in patients undergoing major spinal surgery: a nonrandomized controlled study of two different methods of preoperative and intraoperative warming. Journal of PeriAnesthesia Nursing, 2019; 34(5):999-1005.doi: 10.1016/j.jopan.2019.03.004.
• 26. Yang HL, Lee HF, Chu TL, Su YY, Ho LH, Fan JY. The comparison of two recovery room warming methods for hypothermia patients who had undergone spinal surgery. Journal of Nursing Scholarship, 2012;44(1):2-10. doi: 10.1111/j.1547-5069.2011.01426.x.
• 27. Hassani V, Chaichian S, Rahimizadeh A, Darabi ME, Nobahar MR, Moghaddam MJ, ... & Moradi Y. Comparative study of the effect of warming at various temperatures on biochemical, hematologic, and hemodynamic parameters during spinal fusion surgery under intravenous anesthesia. Anesthesiology and pain medicine, 2018;8(4). doi: 10.5812/aapm.79814.
• 28. Zhang R, Chen X, Xiao Y. The effects of a forced-air warming system plus electric blanket for elderly patients undergoing transurethral resection of the prostate: A randomized controlled trial. Medicine, 2018;97(45). doi: 10.1097/MD.0000000000013119.
• 29. Andrzejowski J, Hoyle J, Eapen G, Turnbull D. Effect of prewarming on post-induction core temperature and the incidence of inadvertent perioperative hypothermia in patients undergoing general anaesthesia. British Journal of Anaesthesia, 2008; 101(5):627-631. doi: 10.1093/bja/aen272.
• 30. Boet S, Patey AM, Baron JS, Mohamed K, Pigford AAE, Bryson GL, ... & Grimshaw JM. Factors that influence effective perioperative temperature management by anesthesiologists: a qualitative study using the Theoretical Domains Framework. Canadian Journal of Anesthesia/Journal canadien d'anesthésie, 2017; 64(6): 581-596. doi: 10.1007/s12630-017-0845-9.
• 31. Mohammadi SS, Jabbarzadeh S, Movafegh A. Efficacy of granisetron on prevention of shivering, nausea and vomiting during cesarean delivery under spinal anesthesia: A randomized double-blinded clinical trial. Journal of Obstetric Anaesthesia and Critical Care, 2015; 5(1): 22.
• 32. Nalivaiko E. Thermoregulation and nausea. In Handbook of Clinical Neurology, 2018; 156:445-56. doi: 10.1016/B978-0-444-63912-7.00027-8.
• 33. Ayhan S, Ballı SS, Fırat AC, Kayhan Z. Is hypothermıa preventable durıng cesarean sectıon under spınal anesthesıa?. Journal of Anesthesia – JARSS, 2018; 26(4):238–244.
• 34. Jeyadoss J, Thiruvenkatarajan V, Watts RW, Sullivan T, Van Wijk RM. Intraoperative hypothermia is associated with an increased intensive care unit length-of-stay in patients undergoing elective open abdominal aortic aneurysm surgery: A retrospective cohort study. Anaesthesia and intensive care, 2013;41(6):759-764.
• 35. Chung SH, Lee BS, Yang HJ, Kweon KS, Kim HH, Song J, Shin DW. Effect of preoperative warming during cesarean section under spinal anesthesia. Korean journal of anesthesiology, 2012;62(5):454.
• 36. De Boer HD, Detriche O, Forget P. Opioid-related side effects: Postoperative ileus, urinary retention, nausea and vomiting, and shivering. A review of the literature. Best Practice & Research Clinical Anaesthesiology, 2017;31(4):499-504. doi: 10.1016/j.bpa.2017.07.002.
• 37. Langford R, Ashton-Cleary D. (Eds.). Kay Clinical Topics in Anaesthesia. 2014. JP Medical Ltd.
• 38. Sessler DI. Perioperative thermoregulation and heat balance. The Lancet, 2016; 387(10038):2655-2664.