Title: Evaluation of Postoperative Pyrexia within 48 Hours of Elective Surgery in General Surgical Ward of Rajah Muthiah Medical College and Hospital
Authors: Dr Guru Praveen, Dr N.Junior Sundresh, Dr D.Gopikrishna, Dr R.Logesh Kumar, Dr P.Vigneshwaran
DOI: https://dx.doi.org/10.18535/jmscr/v8i11.40
Abstract
Background: Fever or pyrexia is a disorder of body’s thermoregulation. Fever has been reported in 40% of patients after major surgery which may arise from either infectious or non-infectious causes. It may be an early presentation of a potentially fatal problem, or part of a more benign process, such as atelactasis or drug fever, infectious and non infectious causes. This study is based on the early evaluation of pyrexia of a post operative patient, identifying the cause reducing the complications
Aim and Objectives: To evaluate causes of postoperative pyrexia within 48 hours of elective surgery in a post operative surgical ward
Methods: This is a descriptive prospective study of 100 cases with operative pyrexia in post operative wards of Rajah Muthiah Medical College from 2018 to 2020. Elective surgical patients who had temperature of 38 C or more within 48 hrs was analyzed Causes of postoperative fever evaluated on the basis of history, clinical examination and with the aid of investigations. The data supporting this study includes kind of surgery performed, clinical symptoms & signs and specific investigations during postoperative period.
Results: Most common cause of fever within 48 hours was atelactasis in 55%. Other causes were Thirty six percent patients were diagnosed as cases of unexplained fever as clinical findings and investigations including chest radiographs did not show any abnormality. Clinical examination of 03 cases showed pain, redness and swelling at cannula site. On clinical correlation they were diagnosed as case of phlebitis. Urinary tract infection occurred in six patients.
Conclusion: In this study non infectious causes shows more incidence of post operative pyrexia. In this study Atlectasis is the most common cause within 48 hrs of post operative pyrexia, further studies have to done to rule out more causes and for more time period with more number of cases.
Keywords: Post-operative, fever, pyrexia, atelactasis.
References
- Russell RCG, Williams NS, Bulstrode CJK. Bailey & Love’s Short Practice of Surgery. 27th London. Arnold 2004; 1439.
- Ghosh, S, Charity, RM, Haidar, SG, Singh, BK. Pyrexia following total knee replacement. Knee 2006; 13: 324.
- Gerard M,Doherty, SeanJ. Postoperative complications. In: Lawrence W, Gerard M. Current Surgical Diagnosis and Treatment. 11Mc Graw-Hill 2001; 36-37.ed. NewYork
- Patchen Dellinger; Should We Measure Body Temperature for Patients who have recently undergone Surgery? Clinical Infectious Diseases 2005;40:1411-1412.
- Dinarello CA, Gelfand JA. Fever and hyperthermia. In: Harrison's principles of internal medicine.16th McGraw Hill: 2005.p.104-7
- McAlister, FA, Bertsch, K,Man, J, et al. Incidence of and risk factors for pulmonary complications after nonthoracic surgery. AmJ Respir Crit Care Med 2005; 171:51
- Wylieand Churchill-Davidson’s-A Practice of Anaesthesia. 7th London: Arnold 2003.
- TusmanG, Bohm SH, Vazquezde Anda GF, do Campo JL, Lachmann B. ‘Alveolar recruitment strategy’ improves arterial oxygenation during general anaesthesia. Br J Anaesth 1999; 82:8-13.
- Sandham, JD, Hull, RD, Brant, RF, et al. A randomized, controlled trial of the use of pulmonary- artery catheters in high-risk surgical patients. N Engl J Med 2003;348:5.