Clinical considerations in the use of forced-air warming blankets during orthognathic surgery to avoid postanesthetic shivering

Abstract

BackgroundDuring head and neck surgery including orthognathic surgery, mild intraoperative hypothermia occurs frequently. Hypothermia is associated with postanesthetic shivering, which may increase the risk of other postoperative complications. To improve intraoperative thermoregulation, devices such as forced-air warming blankets can be applied. This study aimed to evaluate the effect of supplemental forced-air warming blankets in preventing postanesthetic shivering.MethodsThis retrospective study included 113 patients who underwent orthognathic surgery between March and September 2015. According to the active warming method utilized during surgery, patients were divided into two groups: Group W (n = 55), circulating-water mattress; and Group F (n = 58), circulating-water mattress and forced-air warming blanket. Surgical notes and anesthesia and recovery room records were evaluated.ResultsInitial axillary temperatures did not significantly differ between groups (Group W = 35.9 ± 0.7℃, Group F = 35.8 ± 0.6℃). However, at the end of surgery, the temperatures in Group W were significantly lower than those in Group F (35.2 ± 0.5℃ and 36.2 ± 0.5℃, respectively, P = 0.04). The average body temperatures in Groups W and F were, respectively, 35.9 ± 0.5℃ and 36.2 ± 0.5℃ (P = 0.0001). In Group W, 24 patients (43.6%) experienced postanesthetic shivering, while in Group F, only 12 (20.7%) patients required treatment for postanesthetic shivering (P = 0.009, odds ratio = 0.333, 95% confidence interval: 0.147–0.772).ConclusionsAdditional use of forced-air warming blankets in orthognathic surgery was superior in maintaining normothermia and reduced the incidence of postanesthetic shivering.

Mapeamento cruzado das intervenções aplicadas ao diagnóstico de enfermagem: risco de hipotermia perioperatória

“…Estes, publicados, em sua maioria, no ano de 2019, na língua inglesa, e de autoria conjunta com enfermeiros. Com base na análise dos artigos, organizou-se os dados em um quadro, destacando as atividades de enfermagem, conforme descrito no Quadro 1 5,6,[8][9][10]12,[16][17][18][19][20][21] .…”

The opinions of ambulance personnel regarding using a heated mattress for patients being cared for in a cold climate – An intervention study in ambulance care

“…Cooling the back is an effective way of making a person feel less well or feel uncomfortable in the situation in which they find themselves [31]. In one study conducted on post-operative patients, the best method for regaining warmth was to apply active warming from both above and below [32]. Tsuei and Kearney [15] describe that applying heat through convection and conduction is the best way of warming a patient.…”

Effect of forced-air warming blanket position in elective lumbar spine surgery: Intraoperative body temperature and postoperative complications

“…This may result in a decrease in core temperature up to 6. [2,5] Interestingly, perioperative hypothermia is linked to multiple postoperative complications, including increased surgical bleeding, surgical site infection, myocardial events, and increased length of hospital stay. [2]…”

“…Potential preventative measures utilized in many operating rooms include warming the patient preoperatively, increasing the temperature in the operating room, active warming during surgery, passive warming during surgery, prewarming intravenous fluids and blood products, prewarming irrigation fluids, and prewarming administered airway gases. [5] Active warming through forced-air warming blankets, such as Bair Hugger ® , is an effective method for combating intraoperative hypothermia. [1,5] Despite the wide use of forced-air warming blankets, there are no guidelines for where to position the blanket during spine surgery, either below the lower body or over the upper body [Figure 1].…”

“…[5] Active warming through forced-air warming blankets, such as Bair Hugger ® , is an effective method for combating intraoperative hypothermia. [1,5] Despite the wide use of forced-air warming blankets, there are no guidelines for where to position the blanket during spine surgery, either below the lower body or over the upper body [Figure 1]. We aimed to determine the effects of Bair Hugger positioning during elective lumbar spine surgery on intraoperative body temperature and perioperative complications.…”