Value of Extended Warming in Patients Undergoing Elective Surgery

Abstract

Perioperative temperature management is imperative for positive surgical outcomes. This study assessed the clinical and wellbeing benefits of extending normothermia by using a portable warming gown. A total of 94 patients undergoing elective surgery were enrolled. They were randomized pre-operatively to either a portable warming gown or the standard warming procedure. The warming gown stayed with patients from pre-op to operating room to postrecovery room discharge. Core temperature was tracked throughout the study. Patients also provided responses to a satisfaction and comfort status survey. The change in average core temperature did not differ significantly between groups (P ¼ 0.23). A nonsignificant 48% relative decrease in hypothermic events was observed for the extended warming group (P ¼ 0.12). Patients receiving the warming gown were more likely to report always having their temperature controlled (P ¼ 0.04) and significantly less likely to request additional blankets for comfort (P ¼ 0.006). Clinical outcomes and satisfaction were improved for patients with extended warming.

The Effectiveness of Four Intervention Methods for Preventing Inadvertent Perioperative Hypothermia During Total Knee or Total Hip Arthroplasty

“…Perioperative anxiety is a common problem for a major portion of patients undergoing surgery, and research indicates that patients experience increased anxiety associated with thermal discomfort . A subjective perception of cold also might lead to patient discomfort and trigger anxiety, which are main components of acute pain …”

Meta‐analysis: effectiveness of forced‐air warming for prevention of perioperative hypothermia in surgical patients

“…This indicates that the majority of patients feel cold during anaesthesia and surgery. Therefore, healthcare workers should actively provide insulation/warming devices to improve patients' thermal comfort and satisfaction (Wasfie & Barber ).…”

Inadvertent Perioperative Hypothermia: A Literature Review of an Old Overlooked Problem

“…It is essential to keep the warming blanket dry, as the irrigation fluid may easily make it wet. Patients wearing warming gown are more likely to report normal body temperatures, and less likely to ask for additional blankets (13) . Heat loss through the skin can be reduced by passive insulation, but most patients need active warming to save normal temperature (26).…”

“…PH may lead to some postoperative complications (14), including drug metabolism impairment, prolonged recovery from anesthesia, high plasma catecholamine concentration, cardiac morbidity, coagulopathy, impaired wound healing, wound infections, postoperative shivering, systemic and pulmonary vasoconstriction, increased arterial blood pressure, sympathetic hyperactivation, variations in serum potassium levels, impaired function of neutrophils and macrophages, and decreased partial oxygen pressure (1,6,8,13,(15)(16)(17).…”

“…Finally, a core temperature plateau is reached, remaining constant till the end of surgery. The plateau happens passively, or results from the re-emergence of thermoregulatory mechanism in hypothermic patients (13).…”