Efficacy of Forced-air Warming and Warmed Intravenous Fluid for Prevention of Hypothermia and Shivering During Caesarean Delivery Under Spinal Anaesthesia: A Randomized Controlled Trial

Jiang, Jun; Chung, Moon Sang; Jun, In Gu; Kim, Y.; Kim, H.; Kim, J.H.; Choi, Yun-joo; Choi, Eunkyung

doi:10.1097/01.aoa.0000652852.68952.5e

Cited by 3 publications

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“…[ 3 , 44 ] ERAS society recommended that “Appropriate patient temperature is needed to apply warming devices and avoid hypothermia (recommendation grade: strong).” [ 3 ] Active warming (IV fluid combined with force-air warming) can effectively reduce peri-operative hypothermia and shivering, improve maternal thermal comfort, facilitate bonding, and faster PACU times. [ 45 , 46 ] A modest increase of OR temperature (>72°F/22°C) may reduce the rate of maternal and neonatal hypothermia. [ 47 ]…”

Section: Role Of Anesthesiologist In Eracmentioning

confidence: 99%

Enhanced recovery after cesarean delivery: a challenge for anesthesiologists

Liu

Yao

2020

Chinese Medical Journal

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Enhanced recovery after cesarean (ERAC) delivery is an evidence-based, multi-disciplinary approach throughout pre-, intra-, post-operative period. The ultimate goal of ERAC is to enhance recovery and improve the maternal and neonatal outcomes. This review highlights the role of anesthesiologist in ERAC protocols. This review provided a general introduction of ERAC including the purposes and the essential elements of ERAC protocols. The tool used for evaluating the quality of ERAC (ObsQoR-11) was discussed. The role of anesthesiologist in ERAC should cover the areas including management of peri-operative hypotension, prevention and treatment of intra- and post-operative nausea and vomiting, prevention of hypothermia and multi-modal peri-operative pain management, and active pre-operative management of unplanned conversion of labor analgesia to cesarean delivery anesthesia. Although some concerns still remain, ERAC implementation should not be delayed. Regular assessment and process improvement should be imbedded into the protocol. Further high-quality studies are warranted to demonstrate the effectiveness and efficacy of the ERAC protocol.

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Section: Role Of Anesthesiologist In Eracmentioning

confidence: 99%

Enhanced recovery after cesarean delivery: a challenge for anesthesiologists

Liu

Yao

2020

Chinese Medical Journal

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“…Shivering is uncomfortable and can interfere with patient monitoring. It could change the patient's physiology by increasing oxygen consumption, increase the depth of pain, affect the parturient's delivery experience [3,4], as well as many postoperative complications such as surgical site infection, myocardial ischemia, and peri-operative coagulopathy [5].…”

Section: Introductionmentioning

confidence: 99%

The relationship between core temperature and perioperative shivering during caesarean section under intrathecal anesthesia with bupivacaine and ropivacaine: a randomized controlled study

et al. 2021

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Purpose To assess the incidence rate of perioperative shivering for cesarean section and explore the associations between the occurrence of shivering and hypothermia, core temperature change, local anesthetic. Methods This is a prospective, randomized, controlled, double-blinded study of 100 patients consenting for caesarean section under intrathecal anesthesia. Parturients with ASA I or II accepted elective caesarean section with combined spinal-epidural anesthesia (SA). 2–2.5 ml of 0.5% bupivacaine or 0.5% ropivacaine was intrathecally injected in group B and group R, respectively. Results The intraoperative shivering incidence in group B was significantly higher than that in group R (66.7 vs. 20.5%, Pvalue < 0.001), and shivering intensity in group B was significantly greater than group R (score: 1.4 vs. 0.3, Pvalue < 0.001). The core temperature in both groups gradually decreased with the time after SA. Hypothermia (core temperature < 36.0 ℃) 5–30 min after SA was not associated with shivering. However, changes of temperature at 25 and 30 min after SA, and bupivacaine were statistically associated with shivering, with the odds of 10.77 (95% CI: 1.36–85.21, P value = 0.02), 8.88 (95% CI: 1.29–60.97, P value = 0.03), and 7.78 (95% CI: 2.94–20.59, P value < 0.01), respectively. Conclusions In our study, for cesarean section, the occurrence of shivering was associated with the local anesthetics and the change of core temperature after SA, while not the hypothermia.

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Prewarming for Prevention of Hypothermia in Older Patients Undergoing Hand Surgery Under Brachial Plexus Block

Cho

Chang

Lee

et al. 2022

Ann Geriatr Med Res

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Background: Older patients are more vulnerable to inadvertent perioperative hypothermia. Prewarming contributes to the prevention of inadvertent perioperative hypothermia in patients under general or neuraxial anesthesia. However, the effects of brachial plexus block (BPB) on thermoregulation and the efficacy of prewarming in the prevention of hypothermia in older patients undergoing surgery with BPB remain unclear. This study evaluated the effects of BPB on thermoregulation and the efficacy of prewarming during BPB in older patients.Methods: Patients aged ≥65 years were randomly allocated to receive either standard preoperative insulation (control group, n=20) or preanesthetic forced-air warming for 20 minutes before BPB (prewarming group, n=20). During the perioperative period, tympanic temperatures were measured. Thermal comfort scores and shivering grades were also obtained.Results: The tympanic temperatures at the end of surgery did not differ between the groups (36.9°C±0.5°C and 37.0°C±0.4°C in the control and prewarming groups, respectively; p=0.252). The maximum temperature change was significantly lower in the prewarming group compared to the control group (0.36°C±0.4°C and 0.65°C±0.3°C, respectively; p=0.013). The hypothermia incidence and severity, thermal comfort scores, and shivering grades did not differ between the groups.Conclusion: Regardless of the application of prewarming, BPB did not cause a clinically significant impairment of thermoregulation. Moreover, the efficacy of prewarming appeared to be low; thus, it may not be routinely required in patients undergoing orthopedic hand surgery under BPB.

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Efficacy of Forced-air Warming and Warmed Intravenous Fluid for Prevention of Hypothermia and Shivering During Caesarean Delivery Under Spinal Anaesthesia: A Randomized Controlled Trial

Cited by 3 publications

References 0 publications

Enhanced recovery after cesarean delivery: a challenge for anesthesiologists

Enhanced recovery after cesarean delivery: a challenge for anesthesiologists

The relationship between core temperature and perioperative shivering during caesarean section under intrathecal anesthesia with bupivacaine and ropivacaine: a randomized controlled study

Prewarming for Prevention of Hypothermia in Older Patients Undergoing Hand Surgery Under Brachial Plexus Block

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