Perioperative problems: threats to thermal balance in the elderly

The perioperative period is a time of thermal instability for older surgical patients. Beyond the elder persons vulnerability to intraoperative heat loss and hypothermia, the surgical procedure initiates host responses that affect body temperature. Technology and drug therapies often deliberately or inadvertently alter thermal balance. Alterations range from mild hypothermia to shaking febrile chills. A reasoned approach to preventing or caring for each of these alterations is based on an understanding of the dynamics of heat loss or heat gain. Early recognition of problems and appropriate action by perioperative nurses may forestall more serious consequences.