What do you care about temperature management in anaesthesia?
During anaesthesia, body temperature management is an important part of ensuring the safety and well-being of patients. As the elderly population grows, the management of the body temperature of elderly patients in anaesthesia is receiving increased attention. Since older patients are more sensitive to changes in body temperature during anaesthesia and the complexity of body temperature management increases, it is important to understand their characteristics and the corresponding management strategies. First, the biological characteristics of older patients 1. Reduction in the basic metabolic rate: the general reduction in the basic metabolic rate of older patients compared to young people means that they are less able to produce heat during anaesthesia and may be more likely to experience a decrease in body temperature. 2. Decline in body temperature regulation: As age increases, the physiological mechanisms of body temperature regulation may change, especially the ability of the central nervous system to regulate body temperature, leading to a reduction in the resilience of older patients to external temperature changes. 3. Changes in skin and fat tissues: the reduction in skin thickness and elasticity of older patients, and the reduction in subcutaneous fats have made them more sensitive to dissipation of body temperature and reduced capacity to store heat when adjusting body temperature. 4. Accompanying chronic diseases: Many older patients suffer from both cardiovascular diseases and chronic diseases such as diabetes, which may affect their ability to regulate their body temperature and metabolize. For example, persons with cardiovascular diseases may be more likely to suffer from heart disorders at low temperature, while those with diabetes may suffer from abnormally regulated body temperature due to microvascular disease. II. Characteristics of temperature change in the anaesthesia process 1. Effects of anaesthesia: Certain narcotic drugs (e.g. inhalation of anaesthesia and certain intravenous anesthesia) may lead to inhibition of the control centres for body temperature and further increase the risk of a decrease in the body temperature of elderly patients during anaesthesia. 2. Environmental factors in surgery: Operating rooms usually maintain low temperatures to reduce the risk of bacterial infections, which can lead to a rapid decline in body temperature for older patients. At the same time, there may be significant loss of body fluids during anaesthesia, which also accelerates the decline in body temperature. 3. Increased demand for body temperature monitoring: older patients may experience more significant temperature fluctuations during anaesthesia due to their physiological characteristics, requiring more frequent and accurate body temperature monitoring to ensure timely detection of anomalies. III. Challenge 1. Risk of temperature reduction for older patients: The prevalence of low temperature (36°C) during anaesthesia among elderly patients not only affects the smooth operation, but can also cause a range of complications, such as infections, cardiovascular events and delays in post-operative recovery. 2. Complexity of monitoring and response: due to the diversity of the physical state of older patients, the response to changes in body temperature varies, and health-care personnel need to be sensitive to observational capabilities and rapid response strategies to deal with abnormalities. 3. Individual differences are significant: each elderly patient ‘ s basic health status, body temperature control capacity and response to anaesthesia are different and therefore require an individualized temperature management programme. IV. Specific measure 1. Pre-operative assessment: Prior to the operation, a comprehensive temperature management risk assessment should be conducted for older patients to understand their underlying temperature, health status and diseases that may affect the temperature regulation. 2. Preheating measures: Before the operation, the patient can be preheated by equipment such as heating blankets, heaters, etc., in order to increase his or her base temperature and reduce the risk of a decrease in his or her body temperature in the operation. 3. Maintenance of a warm operating environment: During the operation, it should be ensured that the operating room is temperature-appropriate and that the patient is protected by equipment such as heat blankets and heating pads to reduce heat loss. 4. Precision temperature monitoring: use of high-precision body temperature monitoring equipment to monitor changes in patient ‘ s body temperature in real time to ensure timely detection of anomalies and to take appropriate measures. 5. Artificial rehydration strategy: For elderly patients in need of rehydration, the choice of rehydration liquids of warm heat avoids the use of cryogenic liquids, thereby reducing the risk of further reduction of body temperature. 6. Post-operative temperature management: Following the operation, the elderly patients continue to monitor their temperature and take the necessary heating measures to ensure that they maintain appropriate body temperature during recovery. Summarizing the fact that body temperature management is a complex and important component of the anaesthesia of older patients. Medical personnel need to be fully aware of the physiological characteristics of older patients, the effects of narcotic drugs and the effects of the operating environment on body temperature, and to develop individualized temperature management programmes to ensure the safety and comfort of older patients during the operation. Science-based body temperature monitoring and management can effectively reduce the incidence of low-temperatures, promote patient recovery and increase the success rate of surgery.
