Effects of postoperative active warming and early exercise on postoperative body temperature distribution: Non‐blinded and randomized controlled trial

Abstract

AimWe tested a hypothesis that postoperative active warming and/or arm leg stretches reduce the difference between core and skin temperatures (primary variable) improving the peripheral circulation immediately after major abdominal surgery.MethodsFifty‐one patients undergoing major abdominal surgeries were randomly assigned to receive one of three interventions immediately after surgery; routine care (control group), mild intermittent exercise on the bed (exercise group), and forced‐air warming (warming group). Core and skin temperatures and perfusion index were continuously measured from anesthesia induction to 12 h after arrival at the ward.ResultsCore body temperature was maintained over 37°C with a relatively greater gap between core and skin temperatures over 1°C and reduced perfusion index in the early postoperative period in the control group. In the warming group, the reduced skin temperature at arrival at the ward approximated to the core temperature leading to significant reduction of the temperature gap and increasing the perfusion index to the preoperative level. Although less evident, both the temperature gap and peripheral perfusion significantly improved in the exercise group after 6 and 8 h after arrival at the ward, respectively.ConclusionsVasoconstriction in response to cessation after anesthesia and surgery serves to maintain core temperature, but impairs peripheral circulation. Active warming and intermittent mild exercise immediately after arrival at the ward reduces the temperature gap and improves peripheral circulation during the early postoperative period. While cost‐effectiveness needs to be considered before clinical application of the intervention, the cost‐free mild exercise may be a feasible option for improving postoperative patient care.

Development of an In-bed Exercise Program to Prevent Postoperative Complications that can be Performed Immediately after Surgery: Experimental Study of Healthy Elderly Participants

“…In our previous study, early postoperative intermittent mild exercise on the bed improved peripheral perfusion [5]. Although the incidence of postoperative complications was not evaluated, the relationship between peripheral perfusion and the incidence of postoperative complications has been clarified in previous studies [6], and exercising immediately after surgery has been suggested to prevent postoperative complications.…”