Comparison of two different uses of underbody forced-air warming blankets for the prevention of hypothermia in patients undergoing arthroscopic shoulder surgery: a prospective randomized study

Abstract

Background Forced-air warming (FAW) is an effective method of preventing inadvertent perioperative hypothermia (IPH). However, its warming effects can be influenced by the style and position of the FAW blanket. This study aimed to compare the effects of underbody FAW blankets being placed under or over patients in preventing IPH. Methods Patients (n=100) undergoing elective arthroscopic shoulder surgery in the lateral decubitus position were randomized into either under body (UB) group or the over body (OB) group (50 per group). The body temperature of the patients was recorded from baseline to the end of anesthesia. The incidences of postoperative hypothermia and shivering were also collected. Results A steady decline in the body temperature was observed in both groups up to 60 minutes after the start of FAW. After 60 minutes of warming, the OB group showed a gradual increase in the body temperature. However, the body temperature still decreased in UB group until 75 minutes, with a low of 35.7℃ ± 0.4℃. Then the body temperature increased mildly and reached 35.8℃ ± 0.4℃ at 90 minutes. After 45 minutes of warming, the body temperature between the groups was significantly different (P < 0.05). The incidence of postoperative hypothermia in the UB group was significantly higher than that in the OB group (P = 0.023). Conclusions The body temperature was significantly better with the use of underbody FAW blankets placed over patients than with them placed under patients. However, there was not a clinically significant difference in body temperature. The incidence of postoperative hypothermia was much lower in the OB group. Therefore, placing underbody FAW blankets over patients is recommended for the prevention of IPH in patients undergoing arthroscopic shoulder surgery. Trial registration This single-center, prospective, RCT has completed the registration of the Chinese Clinical Trial Center at 13/1/2021 with the registration number ChiCTR2100042071. It was conducted from 14/1/2021 to 30/10/2021 as a single, blinded trial in Sichuan Provincial Orthopedic Hospital.

Effects of propofol versus sevoflurane on surgical field visibility during arthroscopic rotator cuff repair: a randomized trial

“…The operating room temperature was maintained at 21℃ ± 1℃, and all IV and irrigation fluids were administered at this temperature. All patients received forced-air warming, and the heater working temperature was set at 43℃ [ 13 ]. A gravity irrigation system that consisted of 2 (3-L) saline bags suspended 70 cm above the surgical shoulder joint was used in this study to create an inflow pressure for adequate intra-articular visualization.…”

Barriers and facilitators to evidence‐based perioperative hypothermia management for orthopaedic patients: A systematic review

“…In particular, the constructs evidence strength and quality, relative advantage and Cost were the most evident, and more barriers than facilitators were apparent (n = 43). Studies discussed evidence strength and quality with perceptions that quality and lack of credible evidence (especially regarding accuracy of temperature measuring devices) were a barrier to guideline implementation (Boet et al, 2017;Brodshaug et al, 2019;Levin et al, 2016;Matos et al, 2018;Munday et al, 2019;Munday et al, 2013;Scanlan, 2018;Simpson & Rodseth, 2019;Yin et al, 2022). Perioperative hypothermia prevention guidelines were also perceived as a low clinical priority (Boet et al, 2017;Duff, Walker, et al, 2014;Gabriel et al, 2019).…”

Effects of Different Forced-air Warming systems on the Core Temperature of Patients: A Manikin and Multi-center Clinical Study

“…It is a common complication in perioperative period, with an incidence of 25%~90% [2]. A series of clinically related in uencing factors may lead to this phenomenon, such as skin exposure in the operating area, patient age, anesthesia or operation type, cold ushing uid, low ambient temperature in the operating room, no heating of intravenous infusion, impaired thermoregulation control, etc [3][4][5]. Perioperative hypothermia increases the risk of surgical incision infection, coagulation dysfunction, increased intraoperative blood loss and postoperative chills, hypothermia also prolongs anesthesia recovery time, delays wound healing, increases hospitalization time, increases medical economic burden and reduces patient satisfaction [4,[6][7][8][9][10].…”