Symptomatic extravasation of irrigation fluid is a rare complication of hip arthroscopy. However, depending on the amount of fluid, intra-abdominal hypertension (IAH) may occur and even develop into abdominal compartment syndrome, which can seriously alter hemodynamic circulation. Therefore, it is important for anesthesiologists to promptly recognize the abnormal signs of IAH for early diagnosis and better clinical outcomes. Nevertheless, these signs are difficult to detect because they are usually obscured when the patient is under anesthesia and masked by surgical drapes. We report a case of IAH under general anesthesia during hip arthroscopy to highlight possible symptoms and signs.
Anesthesia and surgery commonly cause substantial thermal perturbations. Mild hypothermia (33.0∼36.4℃) results from a combination of anesthetic-induced impairment of thermoregulatory control, a cool operating room environment, and factors unique to surgery that promote excessive heat loss. Perioperative mild hypothermia is extremely common and associated with adverse outcomes such as excessive sympathetic nervous system stimulation, prolonged drug metabolism, impaired platelet activity, impaired immune function and postanesthetic shivering. Prevention of perioperative hypothermia and post-anesthetic shivering improves the outcome in terms of reduced cardiac morbidity and blood loss, improved wound healing and shorter hospital stay. Core temperature monitoring, accompanied by passive and active methods to maintain normothermia, should be part of routine intraoperative monitoring for patients at high risk of perioperative hypothermia, particularly patients undergoing body-cavity surgery, surgery greater than 1 hour duration, younger children and the elderly.
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Effect of the ASPAN Guideline on Perioperative Hypothermia Among Patients With Upper Extremity Surgery Under General Anesthesia: A Randomized Controlled Trial Sookyung Kang, Soohyun Park Journal of PeriAnesthesia Nursing.2020; 35(3): 298. CrossRef