8 5
A U G U S T 2 0 1 4 | O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E
normothermic at the end of surgery — but may be quite hypothermic
during surgery. The reason for this is redistribution.
Patient temperature decreases — typically about 1°C — during
redistribution, which takes place within the first hour after induction
of general or neuraxial anesthesia. Warm blood from the core mixes
with cooler blood from peripheral tissues, mostly the arms and legs.
The result is that core temperature decreases, even though body heat
content remains largely unchanged. Redistribution involves a large
flow of heat and occurs even in actively warmed patients. Recovering
from redistribution hypothermia typically takes about an hour, simply
because changing core temperature in something the size of a human
takes time. As a result, the final intraoperative temperatures of active-
ly warmed patients are usually greater than their average intraopera-
tive temperatures.
We don't know —
and may never know
— all the independent
effects core tempera-
ture disturbances at
various times during
surgery have on out-
comes. But there are
compelling reasons to
believe that intraoper-
ative hypothermia is
strongly related to cer-
tain complications,
while post-operative
hypothermia is more
strongly related to oth-
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