Anesth Pain Med.  2020 Jul;15(3):356-364. 10.17085/apm.20027.

Effects of 10-min of pre-warming on inadvertent perioperative hypothermia in intraoperative warming patients: a randomized controlled trial

• Yoo JH
• Ok SY
• Kim SH
• Chung JW
• Park SY
• Kim MG
• Cho HB
• You GW

• KMID: 2504899
• DOI: http://doi.org/10.17085/apm.20027

Abstract

Background
This study aimed to evaluate the efficacy of 10-min pre-warming in preventing inadvertent perioperative hypothermia, which is defined as a reduction in body temperature to less than 36.0℃ during the perioperative period in intraoperative warming patients.
Methods
In this prospective randomized study, 60 patients scheduled for elective surgery under general anesthesia lasting less than 120 min were divided into two groups: the 10-min pre-warming group (n = 30) and the control group (n = 30). Patients in the 10-min pre-warming group were pre-warmed for 10 min in the pre-anesthetic area using a forced-air warmer set at 47ºC. Intraoperatively, we warmed all patients with a forced-air warmer. Body temperature was measured using a tympanic membrane thermometer pre- or postoperatively and a nasopharyngeal temperature probe intraoperatively. Patients were evaluated on the shivering and thermal comfort scale in the pre-anesthetic area and post-anesthesia care unit.
Results
The incidences of intraoperative hypothermia and postoperative hypothermia were similar in both groups (10.7% vs. 28.6%, P = 0.177; 10.7% vs. 10.7%, P = 1.000 respectively). Body temperature was higher in the 10-min pre-warming group (P = 0.003). Thermal comfort during the pre-warming period was higher in the 10-min pre-warming group (P < 0.001). However, postoperative thermal comfort and shivering grades of both groups were similar.
Conclusions
Ten minutes of pre-warming has no additional effect on the prevention of inadvertent perioperative hypothermia in intraoperative warming patients.

Keyword

Forced-air warming; Hypothermia; Preoperative period

Figure

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  Fig. 1. CONSORT diagram.

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  Fig. 2. Perioperative body temperature. Preoperative and postoperative core temperatures of the patients were measured using a tympanic membrane thermometer. Intraoperative core temperature was recorded every 15 min after anesthetic induction using a nasopharyngeal probe. The temperature was higher in the 10-min pre-warming group from 15 min after anesthetic induction to the post-anesthesia care unit (PACU) area. Error bars indicate ± 1 SD of temperature at each time. Baseline: immediately after arrival in the preoperative area, Pre-induction: immediately after the end of warming, Intraoperative 0 min: immediately after nasopharyngeal probe insertion, PACU arrival: immediately after arrival at the PACU, PACU 10, 20, 30 min: 10, 20, and 30 min after arrival at the PACU. *P < 0.05 based on post-hoc testing using Bonferroni’s method.

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