The effect of warmed inspired gases on body temperature during arthroscopic shoulder surgery under general anesthesia

Abstract

BackgroundPerioperative hypothermia can develop easily during shoulder arthroscopy, because cold irrigation can directly influence core body temperature. The authors investigated whether active warming and humidification of inspired gases reduces falls in core body temperature and allows redistribution of body heat in patients undergoing arthroscopic shoulder surgery under general anesthesia.MethodsPatients scheduled for arthroscopic shoulder surgery were randomly assigned to receive either room temperature inspired gases using a conventional respiratory circuit (the control group, n = 20) or inspired gases humidified and heated using a humidified and electrically heated circuit (HHC) (the heated group, n = 20).ResultsCore temperatures were significantly lower in both groups from 30 min after anesthesia induction, but were significantly higher in the heated group than in the control group from 75 to 120 min after anesthesia induction.ConclusionsIn this study the use of a humidified and electrically heated circuit did not prevent core temperature falling during arthroscopic shoulder surgery, but it was found to decrease reductions in core temperature from 75 min after anesthesia induction.

Preoperative interscalene brachial plexus block aids in perioperative temperature management during arthroscopic shoulder surgery

“…Third, a forced-air warming device should have been applied to patients whenever body temperatures fell below 36.5℃ during the operation and below 36℃ in the PACU according to the National Institute for Health and Care Excellence (NICE) clinical guideline 65. This study adopted a lower temperature than that suggested in the NICE guideline before active warming measures, referring to other studies [ 2 3 19 21 ].…”

Heated wire humidification circuit attenuates the decrease of core temperature during general anesthesia in patients undergoing arthroscopic hip surgery

“…There have been many reports of hypothermia less than 36.0℃ in patients undergoing arthroscopic surgery under general anesthesia, especially when large amounts of cold fluid are used despite short operating times [ 2 , 8 , 21 ]. It has been reported that during arthroscopic hip surgery, body temperature tends to decline and the incidence of hypothermia below 35.0℃ was 2.7%.…”

“…Jo et al [ 8 ] reported that core temperatures were significantly higher from 75 minutes to 120 minutes after anesthetic induction with HHC use in arthroscopic shoulder surgery than in a group using an unheated conventional respiratory circuit, but there was no significant difference in hypothermia below 36.0℃ between the two groups. There was a significant difference in core temperature reduction between the two groups, as was found in our study.…”

“…HHC has several advantages besides the maintenance of body temperature. There are many reports that the use of HHC during surgery under general anesthesia attenuates the degree of core temperature reduction and is also effective in shoulder arthroscopic surgery [ 8 ] as well as in spine surgery, and that the use of HHC in spine surgery is effective in reducing intraoperative hemorrhage [ 13 ]. In addition, the effects of heated humidification of the upper airway are lost during ventilation through intubation.…”

“…As an alternative to forced air warmers, heating and humidification through the trachea can be considered. There have been reports that reduction of core temperature can be attenuated from 75 minutes after anesthetic induction by the warming of anesthetic gas during arthroscopic shoulder surgery under general anesthesia [ 8 ]. It has also been reported that airway heating and humidification is even more effective in children than in adults [ 9 ].…”