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http://dx.doi.org/10.4040/jkan.2013.43.3.352

Effects of ASPAN's Evidence-based Clinical Practice Guidelines for Promotion of Hypothermia of Patients with Total Knee Replacement Arthroplasty  

Yoo, Je Bog (Post Anesthetic Care Unit, Samsung Medical Center)
Park, Hyun Ju (Post Anesthetic Care Unit, Samsung Medical Center)
Chae, Ji Yeoun (Post Anesthetic Care Unit, Samsung Medical Center)
Lee, Eun Ju (Post Anesthetic Care Unit, Samsung Medical Center)
Shin, Yoo Jung (Operating Room, Samsung Medical Center)
Ko, Justin Sangwook (Department of Anesthesiology & Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Kim, Nam Cho (College of Nursing, The Catholic University of Korea)
Publication Information
Journal of Korean Academy of Nursing / v.43, no.3, 2013 , pp. 352-360 More about this Journal
Abstract
Purpose: In this study an examination was done of the effects of the American Society of PeriAnesthesia Nurses (ASPAN) Evidence-Based Clinical Practice Guidelines on body temperature, shivering, thermal discomfort, and time to achieve normothermia in patients undergoing total knee replacement arthroplasty (TKRA) under spinal anesthesia. Methods: This study was an experimental study with a randomized controlled trial design. Participants (n=60) were patients who underwent TKRA between December 2011 and March 2012. Experimental group (n=30) received active and passive warming measures as described in the ASPAN's guidelines. Control group (n=30) received traditional care. Body temperature, shivering, thermal discomfort, time to achieve normothermia were measured in both groups at 30 minute intervals. Results: Experimental group had slightly higher body temperature compared to control group (p=.002). Thermal discomfort was higher in the experimental group before surgery but higher in the control group after surgery (p=.034). It decreased after surgery (p=.041) in both groups. Time to achieve normothermia was shorter in the experimental group (p=.010). Conclusion: ASPAN's guidelines provide guidance on measuring patient body temperature at regular intervals and on individualized and differentiated hypothermia management which can be very useful in nursing care, particularly in protecting patient safety and improving quality of nursing.
Keywords
Spinal anesthesia; Hypothermia; Body temperature; Shivering; Discomfort;
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Times Cited By KSCI : 2  (Citation Analysis)
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1 Choi, K. H. (2007). Comparison of the effects of warming methods on body temperature change, shivering, and post-anesthesia recovery in a recovery room. Unpublshed master's thesis, Dongeui University, Busan.
2 Cohen, J. (1988). Statistical power analysis for the behavior science. Hillsdale, NJ: Lawrence Erlbaum.
3 Collins, V. J. (1996). Temperature regulation and heat problem. In V. J. Collins (Ed.), Physiologic and pharmacologic bases of anesthesia (pp. 316-339). Baltimore, NJ: Williams & Wilkins.
4 Cooper, S. (2006). Home study program: The effect of preoperative warming on patients' postoperative temperatures. Association of Operating Room Nurses Journal, 83(5), 1073-1084, 1079-1084.   DOI   ScienceOn
5 Frank, S. M., Raja, S. N., Bulcao, C., & Goldstein, D. S. (2000). Age-related thermoregulatory differences during core cooling in humans. American Journal of Physiology: Regulatory, Integrative and Comparative Physiology, 279(1), R349-R354.
6 Gonzalez, E. R. (1987). Guidelines for cardiopulmonary resuscitation and emergency cardiac care. Clinical Pharmacy, 6(2), 165-166.
7 Hooper, V. D., Chard, R., Clifford, T., Fetzer, S., Fossum, S., Godden, B., et al. (2010). ASPAN's evidence-based clinical practice guideline for the promotion of perioperative normothermia: Second edition. Journal of Perianesthesia Nursing, 25(6), 346-365. http://dx.doi.org/10.1016/j.jopan.2010.10.006   DOI   ScienceOn
8 Jung, H. M., & Kim, M. H. (2000). Effects of a warmed blanket for the relieving of cold discomfort after cesarean section. Journal of Korean Academy of Fundamentals of Nursing, 7(1), 16-29.
9 Kiekkas, P., & Karga, M. (2005). Prewarming: Preventing intraoperative hypothermia. British Journal of Perioperative Nursing, 15(10), 444, 446-447, 449-451.
10 Kim, J. O., Chung, Y., & Park, Y. J. (2008). The effects of warming methods on the anxiety and cold discomfort of patients undergoing operation under spinal anesthesia. The Medical Journal of Chosun University, 33(2), 96-109.
11 Kim, Y. J. (2011). The effect of intraoperative warming on body temperature, shivering, perceived thermal discomfort among patients with spinal surgery. Unpulshed master's thesis, Eulji University, Daejeon.
12 Leeth, D., Mamaril, M., Oman, K. S., & Krumbach, B. (2010). Normothermia and patient comfort: A comparative study in an outpatient surgery setting. Journal of Perianesthesia Nursing, 25(3), 146-151. http://dx.doi.org/10.1016/j.jopan.2010.03.010   DOI   ScienceOn
13 Min, S. H. (2001). Effects of intraoperative warming and anesthetic type on temperature, thermal-discomfort and shivering in the surgical patient. Unpublished master's thesis, Chungnam National University, Daejeon.
14 Nam, S. W., Kwon, S. B., Kim, S. K., Kim, J. S., & Son, S. C. (2005). Effects of low dose propofol on core and peripheral temperatures during spinal anesthesia. Korean Journal of Anesthesiology, 49(1), 53-58.
15 National Collaborating Centre for Nursing and Supportive Care (UK). (2008, April). The management of inadvertent perioperative hypothermia in adults (NICE Clinical Guidelines, No. 65). London: Royal College of Nursing (UK).
16 National Health Insurance Service. (2012). 2011 statistics on major surgeries. Retrieved December 2, 2012, from http://www.nhic.or.kr/portal/site/main/MENU_WBDDG0207/
17 Park, O. B., & Choi, H. (2010). The effect of pre-warming for patients under abdominal surgery on body temperature, anxiety, pain, and thermal comfort. Journal of Korean Academy of Nursing, 40(3), 317-325. http://dx.doi.org/10.4040/jkan.2010.40.3.317   DOI
18 Ng, S. F., Oo, C. S., Loh, K. H., Lim, P. Y., Chan, Y. H., & Ong, B. C. (2003). A comparative study of three warming interventions to determine the most effective in maintaining perioperative normothermia. Anesthesia and Analgesia, 96(1), 171-176.
19 Ohtsuka, N., Yamakage, M., Chen, X., Kamada, Y., & Namiki, A. (2002). Evaluation of four techniques of warming intravenous fluids. Journal of Anesthesia, 16(2), 145-149. http://dx.doi.org/10.1007/s005400200010   DOI   ScienceOn
20 Pacific Books. (2012) Pacific's illustrated medical dictionary. Seoul: Author.
21 Pikus, E., & Hooper, V. D. (2010). Postoperative rewarming: Are there alternatives to warm hospital blankets. Journal of Perianesthesia Nursing, 25(1), 11-23. http://dx.doi.org/10.1016/j.jopan.2009.12.004   DOI   ScienceOn
22 Putzu, M., Casati, A., Berti, M., Pagliarini, G., & Fanelli, G. (2007). Clinical complications, monitoring and management of perioperative mild hypothermia: Anesthesiological features. Acta Bio-Medica: Atenei Parmensis, 78(3), 163-169.
23 Ryu, J. H. (2007). Effect of warming intravenous fluids to prevent hypothermia during surgical operation. Unpublshed master's thesis, Chung-Ang University, Seoul.
24 Sessler, D. I. (2000). Perioperative heat balance. Anesthesiology, 92(2), 578-596.   DOI   ScienceOn