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Online ISSN 1827-1596
SMART 2002 Milan, May 29-31, 2002
PROBLEMS IN ORTHOPEDIC ANESTHESIA
Akça O., Sessler D. I.
From the Neurosciences ICU, Outcomes Research® Institute, Department of Anesthesiology, University of Louisville, Louisville, KY, USA
*Associate Dean for Research, Director Outcomes Research® Institute, Distinguished University Research Chair, Lolita and Samuel Weakley Professor of Anesthesiology, University of Louisville Professor and Vice-Chair, Ludwig Boltzmann Institute, University of Vienna, Vienna, Austria
Perioperative hypotermia is a common, but preventable complication of anaesthesia and surgery. Mild perioperative hypothermia increases the incidence of morbid myocardial outcomes, reduces resistance to surgical wound infections, and prolongs both postanaesthetic recovery and hospitalization. Hypotermia causes a coagulopathy due to inhibition of platelet function. In this short review, we will discuss three studies done in the last 6 years, which explored the influence of perioperative hypotermia and blood loss. All evaluated blood loss during hip arthroplasty and had similar methodologies. Two studies demonstrate that blood loss is increased, expecially during surgery, in hypotermic patients while a third study failed to identify any thermal influence on blood loss. The benefits of mantaining perioperative normothermia on blood loss thus remain unclear. We thus continue to recommend that surgical patients be kept normothermic.