Intrathecal morphine–related perioperative hypothermia in women undergoing cesarean delivery: a retrospective case-control study

Article

Munday, Judy, Osborne, Sonya and Yates, Patsy. 2018. "Intrathecal morphine–related perioperative hypothermia in women undergoing cesarean delivery: a retrospective case-control study." Journal of PeriAnesthesia Nursing. 33 (1), pp. 3-12. https://doi.org/10.1016/j.jopan.2016.04.142
Article Title

Intrathecal morphine–related perioperative hypothermia in women undergoing cesarean delivery: a retrospective case-control study

ERA Journal ID40429
Article CategoryArticle
AuthorsMunday, Judy (Author), Osborne, Sonya (Author) and Yates, Patsy (Author)
Journal TitleJournal of PeriAnesthesia Nursing
Journal Citation33 (1), pp. 3-12
Number of Pages10
Year2018
Place of PublicationUnited States
ISSN1089-9472
1532-8473
Digital Object Identifier (DOI)https://doi.org/10.1016/j.jopan.2016.04.142
Abstract

Purpose: Rates of inadvertent perioperative hypothermia among women undergoing spinal anesthesia for cesarean delivery are reported to be high. Intrathecal morphine has been noted to have a potentially potent effect on thermoregulation. This retrospective case-control study sought to investigate the incidence of perioperative hypothermia in women undergoing cesarean delivery with and without intrathecal morphine and to describe any clinical factors associated with the condition, the identification of which would provide direction for nursing priorities in the care of the condition.

Design: A retrospective case-controlled study design was used.

Methods: The charts of 358women who had undergone emergency or elective cesarean delivery under spinal anesthesia were reviewed: 179 having received intrathecal morphine and 179 having received spinal anesthesia without intrathecal morphine (control group). SPSS (IBM, Armonk, New York), version 22, was used for data analysis, including logistic regression to predict the outcome of hypothermia across the study population.

Findings: There was no significant difference (P= .62; 95% confidence interval, -0.09 to 0.15) in mean postoperative temperature for the morphine group (mean postanesthesia care unit arrival temperature, 35.91 ◦C; standard deviation, 0.59) and the no morphine group (mean postanesthesia care unit arrival temperature, 35.88 ◦C; standard deviation, 0.52). However, within groups, the temperature decline preoperatively to postoperatively was statistically (and clinically) significant.

Conclusions: The results refute the suggestion that intrathecal morphine contributes to greater core temperature decline in this population; however, it does confirm that perioperative hypothermia is a prevalent concern for women undergoing cesarean delivery and that pre-emptive measures should be routinely considered by health care providers.

Keywordscesarean delivery; intrathecal morphine; observational opioids; perioperative hypothermia
ANZSRC Field of Research 2020420501. Acute care
Public Notes

c. by American Society of PeriAnesthesia Nurses.

Byline AffiliationsQueensland University of Technology
Institution of OriginUniversity of Southern Queensland
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Douglas, Clint, Osborne, Sonya, Reid, Carol, Batch, Mary, Hollingdrake, Olivia and Gardner, Glenn. 2014. "What factors influence nurses’ assessment practices? Development of the Barriers to Nurses’ use of Physical Assessment Scale." Journal of Advanced Nursing. 70 (11), pp. 2683-2694. https://doi.org/10.1111/jan.12408
An integrated educational model for continuing nurse education
Duff, Beverley, Gardner, Glenn and Osborne, Sonya. 2014. "An integrated educational model for continuing nurse education." Nurse Education Today. 34 (1), pp. 104-111. https://doi.org/10.1016/j.nedt.2012.11.022
The primacy of vital signs – Acute care nurses’ and midwives’ use of physical assessment skills: a cross sectional study
Osborne, Sonya, Douglas, Clint, Reid, Carol, Jones, Lee and Gardner, Glenn. 2015. "The primacy of vital signs – Acute care nurses’ and midwives’ use of physical assessment skills: a cross sectional study." International Journal of Nursing Studies. 52 (5), pp. 951-962. https://doi.org/10.1016/j.ijnurstu.2015.01.014
Preoperative bathing or showering with skin antiseptics to prevent surgical site infection (Review)
Webster, Joan and Osborne, Sonya. 2015. "Preoperative bathing or showering with skin antiseptics to prevent surgical site infection (Review)." Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD004985.pub5
Perioperative nursing
Sutherland-Fraser, Sally, Osborne, Sonya and Bryant, Kim. 2016. "Perioperative nursing." Hamlin, Lois, Davies, Menna, Richardson-Tench, Marilyn and Sutherland-Fraser, Sally (ed.) Perioperative nursing: an introduction. Marrickville, Australia. Elsevier. pp. 1-29
Author response: missed opportunity related to statistical methods
Osborne, Sonya Ranee, Jones, Lee and Webster, Joan. 2014. "Author response: missed opportunity related to statistical methods." AORN Journal. 99 (6), pp. 675-677. https://doi.org/10.1016/j.aorn.2014.04.002
Incidence and predictors of lower limb split-skin graft failure and primary closure dehiscence in day-case surgical patients
Stankiewicz, Monica, Coyer, Fiona, Webster, Joan and Osborne, Sonya. 2015. "Incidence and predictors of lower limb split-skin graft failure and primary closure dehiscence in day-case surgical patients." Dermatologic Surgery. 41 (7), pp. 775-783. https://doi.org/10.1097/DSS.0000000000000391
The skin safety model: reconceptualizing skin vulnerability in older patients
Campbell, Jill L, Coyer, Fiona M. and Osborne, Sonya R.. 2016. "The skin safety model: reconceptualizing skin vulnerability in older patients." Journal of Nursing Scholarship. 48 (1), pp. 14-22. https://doi.org/10.1111/jnu.12176
Skin preparation of the patient – more than skin deep
Levada, Lilliana and Osborne, Sonya. 2017. "Skin preparation of the patient – more than skin deep." Journal of Perioperative Nursing. 30 (2), pp. 57-59.
Making evidence-based perioperative practices stick: an introduction to an implementation science approach
Osborne, Sonya. 2017. "Making evidence-based perioperative practices stick: an introduction to an implementation science approach." Journal of Perioperative Nursing. 30 (4), pp. 53-55.
New ACORN guideline: perioperative nursing management of posthumous organ procurement
Gore, Amanda and Osborne, Sonya. 2017. "New ACORN guideline: perioperative nursing management of posthumous organ procurement." Journal of Perioperative Nursing. 30 (1 - Autumn), pp. 56-59.
Nursing physical assessment for patient safety in general wards: reaching consensus on core skills
Douglas, Clint, Booker, Catriona, Fox, Robyn, Windsor, Carol, Osborne, Sonya and Gardner, Glenn. 2016. "Nursing physical assessment for patient safety in general wards: reaching consensus on core skills." Journal of Clinical Nursing. 25 (13-14), pp. 1890-1900. https://doi.org/10.1111/jocn.13201
Preoperative warming versus no preoperative warming for maintenance of normothermia in women receiving intrathecal morphine for cesarean delivery: a single-blinded, randomized controlled trial
Munday, Judy, Osborne, Sonya, Yates, Patsy, Jones, Lee and Gosden, Edward. 2018. "Preoperative warming versus no preoperative warming for maintenance of normothermia in women receiving intrathecal morphine for cesarean delivery: a single-blinded, randomized controlled trial." Anesthesia and Analgesia. 126 (1), pp. 183-189. https://doi.org/10.1213/ANE.0000000000002026
Nursing service innovation: a case study examining emergency nurse practitioner service sustainability
Fox, Amanda, Gardner, Glenn and Osborne, Sonya. 2018. "Nursing service innovation: a case study examining emergency nurse practitioner service sustainability." Journal of Advanced Nursing. 74 (2), pp. 454-464. https://doi.org/10.1111/jan.13454
Cohort study of a specialist social worker intervention on hospital use for patients at risk of long stay
Osborne, Sonya, Harrison, Gai, O'Malia, Angela, Barnett, Adrian Gerard, Carter, Hannah E. and Graves, Nicholas. 2018. "Cohort study of a specialist social worker intervention on hospital use for patients at risk of long stay." BMJ Open. 8 (12), pp. 1-6. https://doi.org/10.1136/bmjopen-2018-023127
Adults’ Perspectives on Cultural, Social and Professional Support on End-of-life Preferences
Huang, Ya-Ling, Yates, Patsy, Thorberg, Fred Arne and Wu, Chiung-Jung (Jo). 2019. "Adults’ Perspectives on Cultural, Social and Professional Support on End-of-life Preferences." Collegian: The Australian Journal of Nursing Practice, Scholarship and Research. 26 (6), pp. 621-628. https://doi.org/10.1016/j.colegn.2019.08.005
Does preoperative oral carbohydrate reduce hospital stay? A randomized trial
Webster, Joan, Osborne, Sonya Ranee, Gill, Richard, Chow, Carina Faran Kalan, Wallin, Siobhan, Jones, Lee and Tang, Annie. 2014. "Does preoperative oral carbohydrate reduce hospital stay? A randomized trial." AORN Journal. 99 (2), pp. 233-242. https://doi.org/10.1016/j.aorn.2013.12.003
Quantitative data collection and study validity
Osborne, Sonya and Schneider, Zevia. 2013. "Quantitative data collection and study validity." Schneider, Zevia, Whitehead, Dean, LoBiondo-Wood, Geri and Haber, Judith (ed.) Nursing and midwifery research: methods and appraisal for evidence-based practice. Australia. Elsevier - Mosby. pp. 200-217
Infection control
Osborne, Sonya. 2013. "Infection control." Crisp, Jackie, Potter, Patricia Ann, Taylor, Catherine, Rebeiro, Geraldine and Douglas, Clint (ed.) Potter and Perry's fundamentals of nursing. Chatswood, NSW, Australia. Elsevier - Mosby. pp. 703-752
The ACORN standards - our aide-memoire to professional practice
Osborne, Sonya. 2013. "The ACORN standards - our aide-memoire to professional practice." ACORN: the journal of perioperative nursing in Australia. 26 (4), pp. 14-15.
Clinically-indicated replacement versus routine replacement of peripheral venous catheters [Review]
Webster, Joan, Osborne, Sonya, Rickard, Clare M. and New, Karen. 2013. "Clinically-indicated replacement versus routine replacement of peripheral venous catheters [Review]." Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD007798.pub3
Nursing management: intraoperative care
Shoup, Anita, Reilly, Maureen, Kless, Jack and Osborne, Sonya. 2012. "Nursing management: intraoperative care." Brown, Diane and Edwards, Helen (ed.) Lewis's medical surgical nursing: assessment and management of clinical problems. Australia. Elsevier. pp. 402-420
Factors influencing nurses’ approaches to accommodating cultural needs of cancer patients and their families from different cultures
Huang, Ya-Ling, Yates, Patsy and Prior, Deborah. 2009. "Factors influencing nurses’ approaches to accommodating cultural needs of cancer patients and their families from different cultures." Journal of Clinical Nursing. 18 (24), pp. 3421-3429. https://doi.org/10.1111/j.1365-2702.2009.02938.x
Accommodating the diverse cultural needs of cancer patients and their families in palliative care
Huang, Ya-Ling, Yates, Patsy and Prior, Deborah. 2009. "Accommodating the diverse cultural needs of cancer patients and their families in palliative care." Cancer Nursing. 32 (1), pp. E12-E21. https://doi.org/10.1097/01.NCC.0000343370.16894.b7
Exploring the culture of non-reporting in the perioperative environment
Marshall, J. and Osborne, Sonya. 2007. "Exploring the culture of non-reporting in the perioperative environment." ACORN: the journal of perioperative nursing in Australia. 20 (2), pp. 10-21.
Imperatives and strategies for developing an evidence-based practice in perioperative nursing
Osborne, Sonya and Gardner, Glenn. 2004. "Imperatives and strategies for developing an evidence-based practice in perioperative nursing." ACORN: the journal of perioperative nursing in Australia. 17 (1), pp. 18-24.
Occupational exposures: balancing the costs of prevention vs treatment in operating theatres, with particular focus on double gloving practices
Osborne, Sonya. 2001. "Occupational exposures: balancing the costs of prevention vs treatment in operating theatres, with particular focus on double gloving practices." ACORN: the journal of perioperative nursing in Australia. 14 (2), pp. 16-21.
Care and preventative maintenance of surgical instrumentation: the scrub nurse's responsibility
Osborne, Sonya R.. 1999. "Care and preventative maintenance of surgical instrumentation: the scrub nurse's responsibility." ACORN: the journal of perioperative nursing in Australia. 12 (4), pp. 10-13.
Latex allergy: a perioperative environmental hazard
Osborne, Sonya R.. 1998. "Latex allergy: a perioperative environmental hazard." ACORN: the journal of perioperative nursing in Australia. 11 (4), pp. 26-28.