The Clinical Impact of Ambient Operating Room Temperature and Other Perioperative Factors on Patient Comfort during Wide-awake Hand Surgery Using Local Anesthesia

Document Type : RESEARCH PAPER


1 Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA

2 Rothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia, PA, USA

3 Rothman Orthopaedic Institute


Background: The prevalence of wide-awake hand surgery using local anesthesia has increased substantially. The full
influence of perioperative factors, namely operating room temperature, on patient comfort during these procedures is
presently underreported.
Methods: One hundred and fifty-eight patients undergoing wide-awake hand surgery using local anesthesia were
prospectively enrolled. Surveys with visual analog scale (VAS) were administered after surgery to assess overall
patient comfort (OPC) and patient comfort with temperature (TPC). Operating room temperature at the initiation of the
procedure, surgery type, duration of surgery, tourniquet use and local anesthetic use were all recorded and their impact
on patient comfort analyzed. The VAS used ranged from 1 (least comfortable) to 5 (most comfortable).
Results: Across all patients, the mean OPC was 4.7 (Range: 2 – 5, SD=0.6) and the mean TPC score was 4.7 (Range
2 – 5, SD=0.6). There were weakly negative correlations between room temperature and VAS score for OPC (rs =-0.2,
P=.038) and TPC (rs=-0.2, P=.051). The mean OPC score was lower with tourniquet use [4.6 (SD=0.7) versus 4.9
(SD=0.4), P=.002].
Conclusion: Patient comfort during surgery using local anesthesia is not substantially affected by operating room
temperature. Tourniquet use negatively impacts patient-reported comfort. Continued studies into the optimization of
patient comfort during wide-awake hand surgery are warranted.
Level of evidence: IV


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