Comparison of Perioperative Active or Routine Temperature Management on Postoperative Quality of Recovery in PACU in Patients Undergoing Thoracoscopic Lobectomy: A Randomized Controlled Study

Abstract

Background: Whether intraoperative temperature management can help patients recover quickly in the postanesthesia care unit (PACU) still remains to be investigated. This study aimed to investigate the effect of intraoperative temperature management on the quality of postoperative recovery of patients who underwent pulmonary lobectomy in the PACU. Methods: Totally, 98 patients aged 45-60 years with a body mass index of 20-25 kg/m 2 who underwent elective thoracoscopic lobectomy were enrolled. Patients were categorized into two groups using a random number table: the conventional group received routine intervention to maintain normothermia (Group C, n = 49) and the aggressive group received integrated interventions (Group A, n = 49). In Group C, normothermic fluid was infused intravenously, the heating blanket was turned on when the intraoperative temperature was <35.0 °C, and the warming was stopped when the temperature reached 36.5 °C. In Group A, the fluid heated to 37 °C was infused intravenously, and the heating blanket was used intraoperatively. When the body temperature was >37 °C, the heating blanket was turned off, and when the body temperature was <36.5 °C, the heating blanket was turned on to continue heating. Results: Steward awakening scores at 1 min and 5 min after extubation and PaO 2 levels at 15 min after extubation were higher in Group A than in Group C (P < 0.05); incidence of chills, nausea, and vomiting in the PACU was lower in Group A than in Group C (P < 0.05); and length of stay in the PACU was shorter in Group A than in Group C (P < 0.05). Conclusion:Aggressive intraoperative temperature management of patients undergoing thoracoscopic lobectomy can improve the quality of postoperative recovery in the PACU through a safe and smooth transition compared with routine insulation measures.

Effect of active warming on perioperative cardiovascular outcomes: a systematic review and meta-analysis of randomized controlled trials

“…Results from four trials (5136 patients) [ 19 , 30 – 32 ] showed no significant difference between active warming and passive insulation on perioperative hypotension (RR 0.66, 95% CI 0.15 to 2.85, number of events 24 vs 32). Perioperative arrhythmia was assessed in six trials (5615 patients) [ 16 , 18 , 19 , 31 , 33 , 34 ]. The pooled estimate demonstrated a significant reduction of arrhythmia with active warming strategy (RR 0.28, 95% CI 0.14 to 0.58, number of events 9 vs 37).…”