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.

Keywords: Elderly patients; First hour after induction; Forced-air warming; Hypothermia; Laparoscopic abdominal surgery.

Fig. 1

Flow diagram of pateint enrollment

Fig. 2

Perioperative body temperature. Preoperative and postperative core temperature of patients were measured ussinng tympanic membrane thermometer. Intraoperative core temperature was recorded at 30-min intervals via nasopharyngeal probe after induction of anesthesia. Baseline: immediately after arrival in operation room; intraoperative 0 min: immediately after insertion of nasopharyngeal probe; PACU 0 min: immediately after arrival at PACU; PACU 15, and 30 min: 15 and 30 min after arrival at PACU. * represents P<, 05 compared with Group L, ** represents P < .001 compared with Group L.