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Body Temperature Changes After Inguinal Hernia Repair: Causes & Monitoring

Perioperative temperature fluctuations are common after inguinal herniorrhaphy. Understanding etiology guides management:

Common Causes

  1. Anesthetic-Induced Hypothermia (Most Common):
    • General anesthesia → vasodilation + impaired thermoregulation → core heat redistribution to periphery.
    • Cold OR (19–22°C), cold IV fluids, open abdomen (even small incision) → heat loss.
    • Nadir at 1–2 hrs post-induction; gradual rewarming over 4–6 hrs.
  2. Surgical Stress Response: Tissue trauma → cytokine release (IL-6, TNF-α) → hypothalamic reset → low-grade fever (37.5–38.5°C) POD 0–1. Self-limiting.
  3. Individual Variability: Age, BMI, thyroid status, medications (beta-blockers impair vasoconstriction) affect rewarming speed.
  4. Infection / Complication (Late, >POD 2): SSI, urinary tract infection, pneumonia, DVT/PE → fever >38.5°C, rigors, tachycardia. Requires workup (CBC, CRP, cultures, imaging).
  5. Medication Effects: Opioids (mild hypothermia), antibiotics (drug fever), anticholinergics (impaired sweating).

Monitoring Protocol

  • Core temperature (tympanic/esophageal/bladder) q30min intraop → q4h × 24h postop.
  • Active warming (forced-air blanket) until normothermic (36.5–37.5°C).
  • Trend, don't treat isolated low-grade fever POD 0–1 without other signs.
  • Escalate: fever >38.5°C after POD 2, or any fever + hemodynamic instability / wound signs.

Most fluctuations are benign anesthetic sequelae. Vigilance distinguishes physiologic from pathologic.

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