The Clinical Impact of Ambient Operating Room Temperature and Other Perioperative Factors on Patient Comfort during Wide-awake Hand Surgery Using Local Anesthesia

Background: The prevalence of wide-awake hand surgery using local anesthesia has increased substantially. The full influence of perioperative factors, namely operating room temperature, on patient comfort during these procedures is presently underreported. Methods: One hundred and fifty-eight patients undergoing wide-awake hand surgery using local anesthesia were prospectively enrolled. Surveys with visual analog scale (VAS) were administered after surgery to assess overall patient comfort (OPC) and patient comfort with temperature (TPC). Operating room temperature at the initiation of the procedure, surgery type, duration of surgery, tourniquet use and local anesthetic use were all recorded and their impact on patient comfort analyzed. The VAS used ranged from 1 (least comfortable) to 5 (most comfortable). Results: Across all patients, the mean OPC was 4.7 (Range: 2 – 5, SD=0.6) and the mean TPC score was 4.7 (Range 2 – 5, SD=0.6). There were weakly negative correlations between room temperature and VAS score for OPC (rs =-0.2, P=.038) and TPC (rs=-0.2, P=.051). The mean OPC score was lower with tourniquet use [4.6 (SD=0.7) versus 4.9 (SD=0.4), P=.002]. Conclusion: Patient comfort during surgery using local anesthesia is not substantially affected by operating room temperature. Tourniquet use negatively impacts patient-reported comfort. Continued studies into the optimization of patient comfort during wide-awake hand surgery are warranted.