Effect of prewarming on body temperature in short-term bladder or prostatic transurethral resection under general anesthesia: A randomized, double-blind, controlled trial

Abstract

Perioperative hypothermia causes postoperative complications. Prewarming reduces body temperature decrease in long-term surgeries. We aimed to assess the effect of different time-periods of prewarming on perioperative temperature in short-term transurethral resection under general anesthesia. Randomized, double-blind, controlled trial in patients scheduled for bladder or prostatic transurethral resection under general anesthesia. Eligible patients were randomly assigned to receive no-prewarming or prewarming during 15, 30, or 45 min using a forced-air blanket in the pre-anesthesia period. Tympanic temperature was used prior to induction of anesthesia and esophageal temperature intraoperatively. Primary outcome was the difference in core temperature among groups from the induction of general anesthesia until the end of surgery. Repeated measures multivariate analysis of covariance modeled the temperature response at each observation time according to prewarming. We examined modeled contrasts between temperature variables in subjects according to prophylaxis. We enrolled 297 patients and randomly assigned 76 patients to control group, 74 patients to 15-min group, 73 patients to 30-min group, and 74 patients to the 45-min group. Temperature in the control group before induction was 36.5 ± 0.5 °C. After prewarming, core temperature was significantly higher in 15- and 30-min groups (36.8 ± 0.5 °C, p = 0.004; 36.7 ± 0.5 °C, p = 0.041, respectively). Body temperature at the end of surgery was significantly lower in the control group (35.8 ± 0.6 °C) than in the three prewarmed groups (36.3 ± 0.6 °C in 15-min, 36.3 ± 0.5 °C in 30-min, and 36.3 ± 0.6 °C in 45-min group) (p < 0.001). Prewarming prior to short-term transurethral resection under general anesthesia reduced the body temperature drop during the perioperative period. These time-periods of prewarming also reduced the rate of postoperative complications.Study Registration Registered at ClinicalTrials.gov (Identifier: NCT03630887).

Thoracic Paravertebral Block Decreased Body Temperature in Thoracoscopic Lobectomy Patients: A Randomized Controlled Trial

“…The effectiveness of these precautions, owing to the reduced core-to-periphery gradients, has been confirmed in previous studies. [27][28][29] This study showed that the change in the peripheral temperature (axillary temperature) coincided with the change in the core temperature (lower esophagus temperature), but with a 15-min lag. The explanation may involve the following: (1) as anesthesiarelated hypothermia mainly stems from core-to-periphery heat dissipation, 18 there existed an earlier decrease in the core temperature and (2) the water mattress was near the peripheral temperature monitoring site, so the site was more susceptible to heating.…”

Hot spots and trends in inadvertent perioperative hypothermia: a bibliometric and visualized study

“…It is e cient and convenient, and recommended to be actively used in clinical practice [21][22][23]. Regarding to the warming period, some evidence suggests that extending systemic warming to the preoperative period could be more bene cial than limiting it only to during surgery [24][25][26]. The decrease in body temperature starts just after anesthesia induction due to heat redistribution from core to peripheral compartments [27].…”

Clinical Survey of Current Perioperative Body Temperature Management: What Major Factors Influence Effective Hypothermia Prevention Practice?

“…IIH is one of the most prevalent events faced by anaesthesiologists, with a current prevalence of 20%-70%, [1][2][3][4] even up to 90% decades ago. 5,6 It is a risk factor for a series of postoperative complications, including bleeding and blood product transfusion, 7,8 cardiovascular events, 9,10 postoperative infection, 10,11 shivering, 12 drug metabolism disorder, 13 prolonged stay in the postanaesthetic recovery unit 14 and increased length of hospital stay, 10,11,15 etc. All of these unfavourable consequences lead to increased hospitalisation expense, [16][17][18] patient discomfort, and complains.…”