THE INCIDENCE AND RISK FACTORS FOR INTRA-OPERATIVE HYPOTHERMIA AMONG PAEDIATRIC PATIENTS UNDERGOING GENERAL ANAESTHESIA AT THE KENYATTA NATIONAL HOSPITAL.

Abstract

OBJECTIVE To determine the incidence and risk factors for intra-operative hypothermia in paediatric patients undergoing general anaesthesia at the Kenyatta National Hospital. DESIGN A prospective observational study. SETTING The Kenyatta National Hospital main operating theatres and affiliated satellite operating theatres. SUBJECTS A total of 100 paediatric patients (range; three days to 12 years, mean; 4.1 ± 3.3 years) were enrolled in the study. RESULTS Thirty out of 100 patients developed hypothermia defined as a core temperature < 36 °C recorded at least once during provision of general anaesthesia. Ninety percent of those developing hypothermia were male compared to 63% who remained normothermic (p = 0.006). Proportionally, more than twice as many hypothermic patients had a caudal block (43% versus 20%, p = 0.016) and received 121 ml more of fluid (p = 0.002) compared to the normothermic group. The patients who became hypothermic tended to be colder at induction of anaesthesia (36.6 ± 0.5°C versus 37.0 ± 0.5 °C, p = < 0.0001) but there was no significant difference in the waiting time, time of induction, environmental temperatures or theatre temperatures compared to those not developing hypothermia. There was no significant difference in the BMI between the two groups (14.0 ± 2.9 kg/ m2 versus 15.2 ± 3.5 kg/m2, p = 0.101). CONCLUSION The incidence of intra-operative core hypothermia in paediatric patients undergoing general anaesthesia at the Kenyatta National Hospital is 30%. Gender (male), lower body temperature at induction, use of caudal block and the volume of intravenous fluids infused were significant independent predictors of core hypothermia. The most significant predictor was body temperature at the time of induction of general anaesthesia.