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Comparison of Combined Forced-Air Warming and Circulating-Water-Mattress and Forced-Air Warming Alone in Patients Undergoing Open Abdominal Surgery in Lithotomy Position: a Randomized Controlled Trial

Abstract

The objective of this study was to evaluate the efficacy of warming devices in patients undergoing open abdominal surgery in lithotomy position. This randomized, controlled trial was designed to compare body temperatures of patients undergoing open abdominal surgery in lithotomy position between February and May 2019. After prewarming for 30 min with forced-air using a full-body blanket, patients were randomized to receive intraoperative warming either with forced-air using a blanket covering the upper torso and upper extremities in combination with circulating-water-mattress warming the back (Group I) or with only forced-air using blanket covering the upper torso and upper extremities (Group II). Primary outcome measure was the intraoperative change in core-body temperature using oesophageal temperature probe. A total of 28 patients were randomized. The mean core-body temperatures (Group I: 36.1 SD0.41 vs Group II: 35.9 SD0.53 °C; p=0.139) and intraoperative changes (Group I: 0.41% vs Group II: − 0.001%; p=0.306) were similar. The core-body temperature at the end of the operation correlated with the operating room temperature in Group II (r=0.862, p<0.001), but not in Group I (r=0.323, p=0.259). The combination of forced-air warming and circulating-water-mattress for open abdominal surgery in the lithotomy position may be more beneficial than forced-air warming alone, due to maintenance of the intraoperative mean core-body temperature ≥36°C, despite variations in operating room temperature.

Trial Registry Number: ClinicalTrials.gov Identifier: NCT03824262 (Date of registry: 29 January 2019)

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References

  1. Hasegawa K, Negishi C, Nakagawa F, Ozaki M (2012) Core temperatures during major abdominal surgery in patients warmed with new circulating-water garment, forced-air warming, or carbon-fiber resistive-heating system. J Anesth 26(2):168–173. https://doi.org/10.1007/s00540-011-1306-1

    Article  PubMed  Google Scholar 

  2. Egan C, Bernstein E, Reddy D, Ali M, Paul J, Yang D, Sessler DI (2011) A randomized comparison of intraoperative PerfecTemp and forced-air warming during open abdominal surgery. Anesth Analg 113(5):1076–1081. https://doi.org/10.1213/ANE.0b013e31822b896d

    Article  PubMed  Google Scholar 

  3. Ruetzler K, Kovaci B, Guloglu E, Kabon B, Fleishmann E, Kurz A et al (2011) Forced-air and a novel patient-warming system (vitalHEAT vH2) comparably maintain normothermia during open abdominal surgery. Anesth Analg 112:608–614. https://doi.org/10.1213/ANE.0b013e3181e7cc20

    Article  PubMed  Google Scholar 

  4. De Witte JL, Demeyer C, Vandemaele E (2010) Resistive-heating or Forced-air warming for the prevention of redistribution hypothermia. Anesth Analg 110:829–833. https://doi.org/10.1213/ANE.0b013e3181cb3ebf

    Article  PubMed  Google Scholar 

  5. Bender M, Self B, Schroeder E, Giap B (2015) Comparing netechnology passive warming versus traditional passive warming methods for optimizing perioperative body core temperature. AORN J 102:183.e1–183.e8. https://doi.org/10.1016/j.aorn.2015.06.005

    Article  Google Scholar 

  6. Röder G, Sessler DI, Roth G, Schopper C, Mascha EJ, Plattner O (2011) Intra-operative rewarming with Hot Dog® resistive heating and forced-air heating: a trial of lower-body warming. Anaesthesia 66:667–674. https://doi.org/10.1111/j.1365-2044.2011.06722.x

    Article  PubMed  Google Scholar 

  7. Andrzejowski J, Hoyle J, Eapen G, Turnbull D (2008) Effect of prewarming on post-induction core temperature and the incidence of inadvertent perioperative hypothermia in patients undergoing general anesthesia. Br J Anaesth 101(5):627–631. https://doi.org/10.1093/bja/aen272

    CAS  Article  PubMed  Google Scholar 

  8. Perez-Protto S, Sessler DI, Reynolds LF, Bakri MH, Mascha E, Cywinski J, Parker B, Argalious M (2010) Circulating-water garment or the combination of a circulating water mattress and forced-air cover to maintain core temperature during major upper-abdominal surgery. Br J Anaesth 105(4):466–470. https://doi.org/10.1093/bja/aeq170

    CAS  Article  PubMed  Google Scholar 

  9. Galante D (2007) Intraoperative hypothermia. Relation between general and regional anesthesia, upper- and lower-body warming: what strategies in pediatric anesthesia? Paedtr Anaesth 17(9):821–823. https://doi.org/10.1111/j.1460-9592.2007.02248.x

    Article  Google Scholar 

  10. John M, Ford J, Harper M (2014) Peri-operative warming devices: performance and clinical application. Anaesthesia 69(6):623–638. https://doi.org/10.1111/anae.12626

    CAS  Article  PubMed  Google Scholar 

  11. Alparslan V, Kus A, Hosten T, Ertargin M, Ozdamar D, Toker K, Solak M (2018) Comparison of forced-air warming systems in prevention of intraoperative hypothermia. J Clin Monit Comput 32(2):343–349. https://doi.org/10.1007/s10877-017-0017-z

    Article  PubMed  Google Scholar 

  12. Janicki PK, Higgins MS, Janssen J, Johnson RF, Beattie C (2001) Comparison of two different temperature maintenance strategies during open abdominal surgery: upper body forced-air warming versus whole body water garment. Anesthesiology 95:868–874. https://doi.org/10.1097/00000542-200110000-00014

    CAS  Article  PubMed  Google Scholar 

  13. Ihn CH, Joo JD, Chung HS, Choi JW, Kim DW, Jeon YS, Kim YS, Choi WY (2008) Comparison of three warming devices for the prevention of core hypothermia and post-anesthesia shivering. J Int Med Res 36:923–931. https://doi.org/10.1177/147323000803600508

    CAS  Article  PubMed  Google Scholar 

  14. Min SH, Yoon S, Yoon SH, Bank JH, Seo JH (2018) Randomized trial comparing forced-air warming to the upper or lower body to prevent hypothermia during thoracoscopic surgery in the lateral decubitus position. Br J Anaesth 120(3):555–562. https://doi.org/10.1016/j.bja.2017.11.091

    Article  PubMed  Google Scholar 

  15. Pagnocca ML, Tai EJ, Dwan JL (2009) Temperature control in conventional abdominal surgery: comparison between conductive and the association of conductive and convective warming. Rev Bras Anesthesiol 59(1):56–66. https://doi.org/10.1590/s0034-70942009000100008

    Article  Google Scholar 

  16. Horosz B, Malec-Milewska M (2014) Methods to prevent intraoperative hypothermia. Anaesthesiol Intens Ther 46(2):96–100. https://doi.org/10.5603/AIT.2014.0019

    Article  Google Scholar 

  17. Raed TE, Brozovich M, Caushaj PF (2018) Perioperative hypothermia during colectomy: when do patients get cold? Techn Coloproctol 22:343–346. https://doi.org/10.1007/s10151-018-1793-2

    Article  Google Scholar 

  18. John M, Crook D, Dasari F, Eljalani F, El-Haboby A, Harper CM (2016) Comparison of resistive heating and Forced-air warming to prevent inadvertent perioperative hypothermia. Br J Anaesth 116(2):249–254. https://doi.org/10.1093/bja/aev412

    CAS  Article  PubMed  Google Scholar 

  19. Wagner K, Swanson E, Raymond CJ, Smith CE (2008) Comparison of two convective warming systems during major abdominal and orthopedic surgery. Can J Anaesth 55(6):358–363. https://doi.org/10.1007/BF03021491

    Article  PubMed  Google Scholar 

  20. Fanelli A, Danelli G, Ghisi D, Ortu A, Moschini E, Fanelli G (2009) The efficacy of a resistive heating under-patient blanket versus a forced-air warming system: a randomized controlled trial. Anesth Analg 108(1):199–201. https://doi.org/10.1213/ane.0b013e31818e6199

    Article  PubMed  Google Scholar 

  21. Negishi C, Hasegawa K, Mukai S, Nakagawa F, Ozaki M, Sessler DI (2003) Resistive-heating and forced-air warming are comparably effective. Anesth Analg 96:1683–1687. https://doi.org/10.1213/01.ane.0000062770.73862.b7

    Article  PubMed  Google Scholar 

  22. Matsuzaki Y, Matsukawa T, Ohki K, Yamamoto Y, Nakamura M, Oshibuchi T (2003) Warming by resistive heating maintains perioperative normothermia as well as forced air heating. Br J Anaesth 90:689–691. https://doi.org/10.1093/bja/aeg106

    CAS  Article  PubMed  Google Scholar 

  23. Wadhwa A, Komatsu R, Orhan Sungur M, Barnes P, In J, Sessler D et al (2007) New circulating-water devices warm more quickly than forced-air in volunteers. Anesth Analg 105(6):1681–1187. https://doi.org/10.1213/01.ane.0000289534.65690.ce

    Article  PubMed  Google Scholar 

  24. Taguchi A, Retnaraj J, Kabon B, Sharma N, Lenhardt R, Sessler D et al (2004) Effects of a circulating-water garment and forced-air warming on body heat content and core temperature. Anesthesiology 100(5):1058–1064. https://doi.org/10.1097/00000542-200405000-00005

    Article  PubMed  Google Scholar 

  25. Brauer A (2017) Perioperative Temperature Management. Cambridge University Press

  26. Wartzek T, Mühlsteff J, Imhoff M (2011) Temperature management. Biomed Tech 56(5):241–257. https://doi.org/10.1515/BMT.2011.108

    Article  Google Scholar 

  27. Sessler DI (2001) Complications and treatment of mild hypothermia. Anesthesiology 95(2):531–543. https://doi.org/10.3389/fncel.2020.00112

    CAS  Article  PubMed  Google Scholar 

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Correspondence to Filiz Uzumcugil.

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Institutional Ethics Committee (KA-180037; 2018/16-26) and the Ethics Committee of the Ministry of Health (71146310-511.06-E.201304) approvals were obtained.

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Yasar, P.O., Uzumcugil, F., Pamuk, A.G. et al. Comparison of Combined Forced-Air Warming and Circulating-Water-Mattress and Forced-Air Warming Alone in Patients Undergoing Open Abdominal Surgery in Lithotomy Position: a Randomized Controlled Trial. Indian J Surg 84, 72–78 (2022). https://doi.org/10.1007/s12262-021-02829-8

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  • DOI: https://doi.org/10.1007/s12262-021-02829-8

Keywords

  • Body temperature
  • Colorectal surgery
  • General surgery
  • Heating
  • Hypothermia