The effect of interscalene brachial plexus block with propofol sedation on preventing perioperative hypothermia during arthroscopic shoulder surgery

Abstract

Background: Interscalene brachial plexus block (ISBPB) is commonly used with general anesthesia for postoperative pain management in shoulder surgery. This study investigated the incidence of hypothermia and changes in the body temperature in patients undergoing arthroscopic shoulder surgery under ISBPB with propofol sedation.Methods: This retrospective study enrolled 220 patients who underwent arthroscopic shoulder surgery. Patients were divided into general anesthesia (n = 34) and ISBPB with propofol sedation (n = 186) groups, and medical records were retrospectively compared. In addition, patients from the ISBPB group were further divided according to age (elderly, [≥ 65 years]; n = 98 vs. young, [< 65 years]; n = 88), and the incidence of hypothermia and changes in the body temperature were compared. Results: Twenty-seven patients (12.3%) experienced perioperative hypothermia (range; 35.3–35.9℃). The incidence of perioperative hypothermia was 29.4% and 9.1% in the general anesthesia and ISBPB groups, respectively, and there was a significant difference between the two groups (P = 0.002). The incidence of perioperative hypothermia according to age in the ISBPB group was 9.2% and 9.1% in the elderly and young groups, respectively, and there was no significant difference between the two groups (P = 0.983).Conclusions: The incidence of perioperative hypothermia during arthroscopic shoulder surgery under ISBPB with propofol sedation is lower than that under general anesthesia. Furthermore, when using ISBPB with propofol sedation, the incidence of perioperative hypothermia in elderly patients is similar to that in younger patients.

Incidence of postoperative hypothermia and its risk factors in adults undergoing orthopedic surgery under brachial plexus block: A retrospective cohort study

“…During arthroscopic shoulder surgery, large amounts of irrigation solution are used to ensure the surgical field of view. Although the effects of the use of warmed irrigation solution on the prevention of hypothermia are inconsistent 18 , 19 , un-warmed irrigation solution is absorbed into the systemic circulation and decreases body temperature 20 . Intravenous administration of more than 1 liter of unwarmed fluid increases the risk of hypothermia by nearly three times compared to administration of less than 1 liter of unwarmed fluid 8 .…”

Transparency considerations for describing statistical analyses in research

“…The number (percentage) of the articles that received a score of 3 for the two items (parameters derived from statistical analysis methods and rationale for and details of statistical analysis methods) was 24 (77.4%) and 23 (74.2%), respectively. The studies by Lee et al [ 3 ] and Hervás et al [ 4 ] received scores of 2 for the “rationale for and details of the statistical analysis methods used” item because, although they stated that they used propensity score matching, no descriptions of the adjustment method, caliper value, or the ratio of pair-matching were found, which would significantly affect the results of the subsequent statistical analysis. Likewise, the papers by Lim et al [ 5 ] and Tamboli et al [ 6 ] reported performing statistical analyses without describing the rationale for and details of the statistical analysis methods used.…”

Effects of a preoperative forced-air warming system for patients undergoing video-assisted thoracic surgery

“…[ 39 ] Therefore, it appears that ESPB combined with general anesthesia may be beneficial for perioperative temperature management for patients undergoing VATS. [ 40 ]…”