Abstract: Objective To compare the effects of different body mass index (BMI) on the incidence of intraoperative hypothermia, postoperative infection, complications in the awakening period, and the volume of intraoperative bleeding in the elderly patients undergoing laparoscopic hysterectomy under general anesthesia. Methods The clinical data of 260 elderly patients undergoing laparoscopic hysterectomy under general anesthesia were retrospectively analyzed, and the patients were divided into three groups according to the level of BMI: Group A (BMI<18.5, n=69), Group B (18.5≤BMI≤23.9, n=108) and Group C (BMI≥24.0, n=83). The body temperature of the patients at T1 (entering the operating room), T2 (30 min of operation), T3 (1 h of operation), T4 (at the end of operation), the incidence of intraoperative hypothermia, postoperative infection and complications during the recovery period, and the volume of intraoperative bleeding were recorded and compared. Results Of the 260 elderly patients, 100 patients presented with intraoperative hypothermia (38.46%). There was no significant difference in the body temperature at T1 and T2 among the three groups (P>0.05). The body temperature at T3 and T4 in Group B and Group C was higher than that in Group A (P<0.05), and the body temperature at T3 and T4 in the three groups was higher than that at T1 (P<0.05). There were statistically significant differences in the incidence rates of intraoperative bleeding>200 mL, intraoperative hypothermia, postoperative infection, delayed awakening and chills among the three groups (P<0.05); The above indicators in Group A were higher than those in Group B and Group C. There were no significant differences in the incidence of restlessness during awakening and respiratory amnesia after extubation among the three groups (P>0.05). Conclusions The elderly patients with BMI<18.5 who undergo laparoscopic hysterectomy under general anesthesia have faster temperature drop from the first hour of operation, and the incidence rates of intraoperative hypothermia, intraoperative bleeding>200 mL, postoperative infection and complications during the recovery period are higher.

Key words: body mass index, general anesthesia, laparoscopic hysterectomy, hypothermia, aged