Effect of active forced air warming during the first hour after anesthesia induction and intraoperation avoids hypothermia in elderly patients

Abstract

Background The study aimed at exploring an optimal temperature model of forced air warming during the first hour after induction and intraoperation to prevent hyperthermia for elderly patients undergoing laparoscopic abdominal surgery. Methods There were 218 patients that were randomly divided into 3 groups warmed with a forced-air warmer during surgery: Group L (intraoperative warming set to 38 °C, n = 63), Group H (intraoperative warming set to 42 °C, n = 65) and Group LH (intraoperative warming set to 42 °C for the first hour then set to 38 °C, n = 65). Core temperature in the preoperative room and PACU was measured by a tympanic membrane thermometer and in the operation room, a nasopharyngeal temperature probe was recorded. The rate of perioperative hypothermia, defined as a reduction in body temperature to < 36 °C was recorded as the primary outcome. Intraoperative anesthetic dosage, recovery time, adverse events, thermal comfort and satisfaction score were measured as secondary outcome. Results The incidence of intraoperative and postoperative hypothermia was significantly lower in Group LH and Group H than Group L (18.75 and 15.62% vs 44.44%, P<0.001; 4.69 and 4.69% vs 20.63%, P<.05). Anesthetic dosage of rocuronium was lower in Group L than other two groups, with the opposite result of recovery time. The number of patients with shivering was higher in Group L but sweating was higher in Group H. Both of the thermal comfort and satisfaction score was highest in Group LH. Conclusion A temperature pattern of forced air warming set at 42 °C during the first hour after anesthesia induction and maintained with 38 °C was a suitable choice for elderly patients undergoing laparoscopic abdominal surgery lasting for more than 120 min. Trial registration Chictr.org.cn ChiCTR-2,100,053,211.

Effects of Enhanced Recovery After Surgery (ERAS) on Short-term Clinical Outcomes and Long-term Prognosis of Patients Undergoing Gastric Cancer Surgery

“…multimodal analgesia, preoperative education [20][21][22][23], intraoperative heat preservation [24][25][26], GDFT(Goal-directed uid therapy) [7,27,28] and stress reduction in ERAS.…”

Incidence of postoperative hypothermia and shivering and risk factors in patients undergoing malignant tumor surgery: a retrospective study

“…An age older than 65 years was another risk factor for postoperative hypothermia, as suggested in previous studies [ 16 , 17 ]. Elderly patients, particularly those who are over 65 years old, have less effective regulatory ability of their central nervous system and an increased susceptibility to hypothermia [ 9 ]. As mentioned above, many MT patients possess risk factors for hypothermia, including poor nutritional status, low BMI and advanced age; thus, it is necessary for us to take active measures to prevent hypothermia in this population.…”

“…Thus, many medical specialty societies have provided guidelines for hypothermia prevention, which recommend monitoring the patient's body temperature and providing active warming interventions throughout the perioperative period [7,8]. However, despite the development of some effective active warming techniques, such as forced-air warming systems, self-warming mattresses, and irrigation and infusion of warmed fluids [9][10][11][12], a survey of 6 Asia-Pacific countries showed that compliance with international perioperative temperature management guidelines in the Asia-Pacific remains poor, especially in small hospitals [13].…”

Pressure ulcer and low-temperature burn development in an elderly patient following prolonged surgery with forced-air warming system: A case report

“…Higher temperatures of the forced-air warming device increase the probability of skin damage [13]. Patient satisfaction was higher when adjusting the temperature of the forced-air warming device from a high temperature (42°C) to a medium temperature (38°C) intraoperatively [14].…”