Temperature monitoring and perioperative heat loss

To assess the temperature fall at various stages in the perioperative period and identification of contributing factors. This observational study was carried out at Blackpool Victoria Hospital, UK from August 2005-January 2006 on 32 patients undergoing major lower limb vascular surgery. Semistructured data collection form was designed to record the time and tympanic temperature at different stages in perioperative period and the warming methods used. A median fall of 0.1°C [0-0.5°C] in core temperature was recorded in ward and theatre reception area. The median fall of temperature in the anaesthetic room was 0.3°C [0-.8°C]. Patients [n=16] spending more than 0.5 hour in the anaesthetic room had a significant [p=0.002] temperature drop recorded at 0.4°C as compared to 0.2°C for those spending less than 30 minutes. During operation, a median fall of temperature by 0.8°C [0.3-2.1°C] was recorded. Operations lasting for 2.5 hours or more [n=16] resulted 2 in a 1°C temperature fall as against 0.5°C for the rest. Seven patients, in whom a warming mat was used, had a temperature drop of 0.6°C compared to 0.35°C in patients who received warm touch. In the recovery unit, 23 patients had a further drop of 0.3°C, while 9 patients who were actively warmed gained 0.6°C. Significant heat loss occurs in the anaesthetic room relevant to the length of time consumed in anaesthetising the patient. Furthermore active warming measures in the perioperative period have a positive impact on maintaining core temperature

Comparative study of laparoscopic versus open cholecystectomy

To compare our results of Laparoscopic Cholecystectomy with Open Cholecystectomy regarding case selection, technical difficulties, duration of surgery, operative complications, post operative complications, post operative hospital stay, morbidity and mortality, patient's attitude after operation, operative expenses, total expenses and general impression in the society. Comparative study carried out from January 2002 to December 2005. Department of Surgery, surgical 'D' Ward, Khyber Teaching Hospital, Peshawar. This study was conducted on two hundreds patients, one hundred patients were submitted to Laparoscopic Cholecystectomy and the other hundred to traditional Open Cholecystectomy. These patients were admitted in our unit through Out-door department or in emergency as acute cholecystitis. All patients were thoroughly assessed and necessary investigations carried out. After consent all patients were operated on the next operation list. The patients were randomly assigned to either one of the procedures. There was no significant difference in the selection of patients in the two groups. No mortality was seen in both the groups, but complications were more in the open procedure than the laparoscopic one. There isles pain, less hospitalization, early mobilization and early return to work in the laparoscopic surgery. Laparoscopic Cholecystectomy is a superior procedure in comparison to Open Cholecystectomy as regards to the results. Hence it is recommended as the first choice operation