Abstract
Three main requirements influence the control of the temperatures of operating suites: (1) avoid humidities which contribute to the risks of anaesthetic explosions; (2) promote the comfort and working efficiency of the staff; and (3) conserve the patient's resources.
In the United States, an air temperature of 70 to 75°F. (21 to 24°C.) with 50 to 60% relative humidity provides a compromise between the requirements of the patients and those of the operators. In Britain, a temperature of 65 to 70°F. (18 to 21°C.) and a relative humidity of 50% is “well tolerated for many hours”. In the U.S.S.R., air-conditioning should provide in summer an air temperature of 68 to 72·5°F. (20 to 22°C.) and in winter 66 to 68°F. (19 to 20°C.) with a relative humidity of 55%.
According to the American Society of Heating, Refrigeration and Air-conditioning Engineers (1961) Guide “little is known about optimum air conditions for maintaining normal body temperatures during anaesthesia and the immediate post-operative period”. Clarke and his colleagues' observation in New York City that the patient's temperature begins to rise when the wet-bulb temperature exceeds 75°F.s (23·8°C.) fills one important gap. But this finding may not apply to other populations. Deaths from heat stress have occurred in Britain with wet-bulb temperatures of this order; and in the tropics surgeons operate successfully without air-conditioning where the ambient wet-bulb temperature rarely falls much below 75°F. (23·8°C.). When temperature control is available, it is not only at high temperatures that trouble arises. Excessive cooling of the patient leads to cardiac arrhythmias.
The patient's position is more hazardous than that of those exposed to climatic extremes in industry or in the armed forces. He is not only unconscious but his responses may be poikilothermic in character because shivering is abolished and there is peripheral vasodilatation. When he is exposed to levels of warmth at which he might not maintain thermal equilibrium, his body temperature should be recorded continuously during the period of anaesthesia in the theatre and in the ward.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- CLARK R. E., ORKIN L. R., ROVENSTINE E. A. Body temperature studies in anesthetized man: effect of environmental temperature, humidity, and anesthesia system. J Am Med Assoc. 1954 Jan 23;154(4):311–319. doi: 10.1001/jama.1954.02940380021007. [DOI] [PubMed] [Google Scholar]
- DOUGLAS D. M. Operating-theatre design. Lancet. 1962 Jul 28;2(7248):163–169. doi: 10.1016/s0140-6736(62)90053-3. [DOI] [PubMed] [Google Scholar]
- Danks D. M., Webb D. W., Allen J. Heat Illness in Infants and Young Children. Br Med J. 1962 Aug 4;2(5300):287–293. doi: 10.1136/bmj.2.5300.287. [DOI] [PMC free article] [PubMed] [Google Scholar]
- ELLIS F. P. Tolerable and desirable levels of warmth in warm climates, with special reference to the requirements of men in the Royal Navy. Ann R Coll Surg Engl. 1953 Dec;13(6):369–391. [PMC free article] [PubMed] [Google Scholar]
- HARRIS T. A., HUTTON A. M. Heat-stroke during and after anaesthesia. Lancet. 1956 Nov 17;271(6951):1024–1025. doi: 10.1016/s0140-6736(56)90270-7. [DOI] [PubMed] [Google Scholar]
- MINARD D. Prevention of heat casualties in Marine Corps recruits. Period of 1955-60, with comparative incidence rates and climatic heat stresses in other training categories. Mil Med. 1961 Apr;126:261–272. [PubMed] [Google Scholar]
- STEPHEN C. R. Postoperative temperature changes. Anesthesiology. 1961 Sep-Oct;22:795–799. doi: 10.1097/00000542-196109000-00013. [DOI] [PubMed] [Google Scholar]