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Effect of Prewarming on Perioperative Hypothermia in Patients Undergoing Loco-Regional or General Anesthesia: A Randomized Clinical Trial.
Recio-Pérez, Jesus; Miró Murillo, Miguel; Martin Mesa, Marta; Silva García, Javier; Santonocito, Cristina; Sanfilippo, Filippo; Asúnsolo, Angel.
Afiliação
  • Recio-Pérez J; Department of Anesthesia, Torrejon University Hospital, 28850 Torrejón de Ardoz, Spain.
  • Miró Murillo M; Department of Anesthesia, Torrejon University Hospital, 28850 Torrejón de Ardoz, Spain.
  • Martin Mesa M; Department of Anesthesia, Torrejon University Hospital, 28850 Torrejón de Ardoz, Spain.
  • Silva García J; Department of Anesthesia, 12 Octubre Hospital, 28041 Madrid, Spain.
  • Santonocito C; Department of Anesthesia and Intensive Care, University Hospital "Policlinico-San Marco", 95124 Catania, Italy.
  • Sanfilippo F; Department of Anesthesia and Intensive Care, University Hospital "Policlinico-San Marco", 95124 Catania, Italy.
  • Asúnsolo A; Department of Surgery and Medical-Surgical Specialties, University of Catania, 95124 Catania, Italy.
Medicina (Kaunas) ; 59(12)2023 Nov 27.
Article em En | MEDLINE | ID: mdl-38138185
ABSTRACT
Background and

Objectives:

Redistribution hypothermia occurs during anesthesia despite active intraoperative warming. Prewarming increases the heat absorption by peripheral tissue, reducing the central to peripheral heat gradient. Therefore, the addition of prewarming may offer a greater preservation of intraoperative normothermia as compared to intraoperative warming only. Materials and

Methods:

A single-center clinical trial of adults scheduled for non-cardiac surgery. Patients were randomized to receive or not a prewarming period (at least 10 min) with convective air devices. Intraoperative temperature management was identical in both groups and performed according to a local protocol. The primary endpoint was the incidence, the magnitude and the duration of hypothermia (according to surgical time) between anesthetic induction and arrival at the recovery room. Secondary outcomes were core temperature on arrival in operating room, surgical site infections, blood losses, transfusions, patient discomfort (i.e., shivering), reintervention and hospital stay.

Results:

In total, 197 patients were analyzed 104 in the control group and 93 in the prewarming group. Core temperature during the intra-operative period was similar between groups (p = 0.45). Median prewarming lasted 27 (17-38) min. Regarding hypothermia, we found no differences in incidence (controls 33.7%, prewarming 39.8%; p = 0.37), duration (controls 41.6% (17.8-78.1), prewarming 45.2% (20.6-71.1); p = 0.83) and magnitude (controls 0.19 °C · h-1 (0.09-0.54), prewarming 0.20 °C · h-1 (0.05-0.70); p = 0.91). Preoperative thermal discomfort was more frequent in the prewarming group (15.1% vs. 0%; p < 0.01). The interruption of intraoperative warming was more common in the prewarming group (16.1% vs. 6.7%; p = 0.03), but no differences were seen in other secondary endpoints.

Conclusions:

A preoperative prewarming period does not reduce the incidence, duration and magnitude of intraoperative hypothermia. These results should be interpreted considering a strict protocol for perioperative temperature management and the low incidence of hypothermia in controls.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Hipotermia Limite: Adult / Humans Idioma: En Revista: Medicina (Kaunas) Assunto da revista: MEDICINA Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Espanha

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Hipotermia Limite: Adult / Humans Idioma: En Revista: Medicina (Kaunas) Assunto da revista: MEDICINA Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Espanha