Effect of pre-, post-infusion and post-heating on vital signs and blood parameters of patients undergoing laparoscopic surgery

ABSTRACT The Impact Of The Perioperatve Warming Of Patients Having A Laparoscopic Cholecystectomy Surgery On Vital Findings And Blood Parameters SANKO Unıversity, Institute Of Health Science, Department Of Nursing, Surgical Nursing, Master Thesis, Gaziantep, 2018 This research has been carried out to find out the influence of preoperative, preoperative and postoperative warming in patients having laparoscopic cholecystectomy on vital findings and blood parameters. This study was carried out in the surgery room of Sani Konukoğlu Research and Development Hospital at Gaziantep SANKO University between 1 October 2017 and 31 March 2018. The required permissions were received from the university research ethics committee, from the hospital and from the patients. 66 patients who had a medical operation in the hospital were included in the sampling through sampling method. In the research, those documents such as Patient Monitoring Form, Socio-Demographic Data Collection Form, Physiologic Changes of the Pre-Operative Patient / Laboratory Results Monitoring Form, Physiological Changes of the Patient During the Surgery / Laboratory Findings Monitoring Form and Physiological Changes of the Patient after the Surgery in the Recovery Room were prepared and used. The research was carried out in the following order: Seeing patients before the operation and obtaining their consent, covering patients before the operation, getting information about their socio-demographic background, evaluating their physiological data and laboratory values, warming patients by means of forced-air warming systems – evaluating their laboratory values in the 1st, 5th, 15th and 30th minutes, taking the patients to the recovery room and evaluating the physiological values of the patients after the operations. The dependent variable of the research was warming, while the independent variables of the research were vital findings and blood parameters such as blood pressure, pulse, respiration, saturation, hb, erythroid, leukocyte, lymphocyte, BUN, AST, ALT and APTT. All the socio-demographic data were given in percentages. The body temperatures and physiological findings of the patients and room temperature were also given in percentages. The body temperature and physiological findings of each patient after the operation were evaluated through t test. All of the patients were warmed by means of forced-air warming systems after the operation, and the average operation time for the patients was 74.55+23.40 minute (min: 40, max: 120. The average time for anesthesia was 56.17+23.46 minute (min:20, max:128). IV infusion fluids given to patients and irrigation fluids used during the operation were kept at 37 C. The surgery and recovery rooms were kept at an average temperature of 21 C during the operation. The average body temperature of the patients was 36.36+ 2.81°C (min:35.8, max:37.1; and the average body temperature of them was 36.33+ 2.80°C (min:35.8, max:37.2) (p >0.05). The average arterial pressure of the patients before the operation was (MAP) 102.64+11.529 mm Hg (min:83,max: 142), while the average arterial pressure of the patients in the recovery room after the operation was found to be 98.55+ 9.940 (min:68,max: 134). During the operation, the average of the MAP was between 96 and 98 Hg (p >0.05). The average haemoglobin value of the patients before the operation was 13,31+1.613 gr/dl (min: 10, max:16), while it was 12.96+1.612 gr/dl (min:10, max:16) during the operation. The average preoperative, preoperative and postoperative leukocyte counts of the patients were 8.05+1.744 mm3 (min:4, max:11), 8.05+1.701 mm3 (min: 4.34, max: 11.32), 8. 13+1.600 mm3(min: 4.46, max: 11.12), respectively (p >0.05). The average lymphocyte level of the patients was 2.32+0.926 mm3 (min:1, max:5) before the operation. It was 2.13+0.871 mm3 (min:1, max:5) during the operation, while it was 2.19+0.895 mm3 (min:1, max:5) after the operation (p >0.05). The average preoperative, preoperative and postoperative platelet counts of the patients were 245.06 mm3 (min:139, max:422), 230.45 mm3 (min:103,max:395) and 222.50 mm3(min:117,max:555), respectively (p >0.05). The average preoperative, preoperative and postoperative blood urea nitrogen (BUN) values of the patients having laparoscopic gallbladder surgery were 13.79+ 6.126 (min:6, max:36), sırasında13.70+6.752 (min:6, max:47) and 13.52+7.637(min:6, max:55), respectively (p >0.05). The average preoperative, preoperative and postoperative Activated Partial Thromboplastin Time (APTT) levels of the patients were 30.16+4.201(min:21, max:55), 28.99+4.556 (min:18, max:60) and 29.48+4.029(min:20, max:56), respectively (p >0.05). In conclusion, it can be stated that keeping the preoperative, preoperative and postoperative body temperatures of patients stable helps to affect blood pressure, respiration and oxygenation positively and to normalise those values. It also keeps the erythrocyte, hemoglobin, leukocyte, lymphocyte, thrombocyte, APTT, BUN, AST, ALT values within the normal value range and helps the process of wound healing positively. In order to increase the accuracy rating of this study, it is suggested that more studies having a control group and an experimental group should be carried out. Key Words: Hypothermia; Heating; Operating Room Nursing