Abstract
Background: Perioperative hypothermia (body temperature <36°C) is a common complication of anesthesia increasing the risk for maternal cardiovascular events and coagulative disorders, and can also influence neonatal health. The aim of our work was to evaluate the impact of combined warming strategies on maternal core temperature, measured with the SpotOn. We hypothesized that combined modalities of active warming prevent hypothermia in pregnant women undergoing cesarean delivery with spinal anesthesia.Methods: Seventy-eight pregnant women were randomly allocated into three study groups receiving warmed IV fluids and forced-air warming (AW), warmed IV fluids (WF), or no warming (NW). Noninvasive core temperature device (SpotOn) measured maternal core temperature intraoperatively and for 30 min after surgery. Maternal mean arterial pressure, incidence of shivering, thermal comfort and newborn's APGAR, axillary temperature, weight, and blood gas analysis were also recorded.Results: Incidence of hypothermia was of 0% in AW, 4% in WF, and 47% in NW. Core temperature in AW was constantly higher than WF and NW groups. Incidence of shivering in perioperative time was significantly lower in AW and WF groups compared with the NW group (p < 0.04). Thermal comfort was higher in both AW and WF groups compared with NW group (p = 0.02 and p = 0.008, respectively). There were no significant differences among groups for the other evaluated parameters.Conclusion: Combined modalities of active warming are effective in preventing perioperative hypothermia. The routine uses of combined AW are suggested in the setting of cesarean delivery.
Highlights
Core temperature in air warming (AW) was constantly higher than warmed IV fluids (WF) and no warming (NW) groups
Incidence of shivering in perioperative time was significantly lower in AW and WF groups compared with the NW group (p < 0.04)
Thermal comfort was higher in both AW and WF groups compared with NW group (p = 0.02 and p = 0.008, respectively)
Summary
Perioperative hypothermia is estimated to occur in >60% of patients receiving spinal anesthesia for cesarean delivery [2,3,4], in whom it significantly impairs thermal autoregulation by inhibiting the vasomotor and shivering responses even above the level of the sensory block and causes a thermal redistribution of heat from core to peripheral tissues [5,6,7,8,9]. Hypothermia increases the risk of cardiovascular events, such as myocardial ischemia, arrhythmias, and coagulative disorders, greater blood loss with a need of transfusions, wounds infection with delayed healing due to decreased antibody- and cellmediated immune responses, and oxygen availability in the peripheral wound tissues. Perioperative hypothermia (body temperature
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