Effects of Preanesthetic Forced Air Warming and Administration of Warmed Intravascular Fluid

Hallym University Kangnam Sacred Heart Hospital

Status: Completed

Conditions: Pregnancy

Treatments: Behavioral: Prewarming using forced air warmer, warmed intravenous fluid

Study type: Observational

Funder types: Other

Identifiers

NCT03256786

kangnamAN

Details and patient eligibility

About

The majority of women (> 60%) developed hypothermia and shivering during cesarean delivery. Core hypothermia may be associated with a number of adverse outcomes in patients, including shivering, wound infection, coagulopathy, increased blood loss and transfusion requirements, decreased metabolism and prolonged recovery. Shivering can result in interference with monitoring, increased tension on wound edges, and increased oxygen consumption.

A previous study has shown several modalities to prevent hypothermia and shivering in patients undergoing cesarean delivery with spinal anesthesia. But, single modality intervention have shown marginal or no efficacy.

Neuraxial anesthesia reduces the threshold for vasoconstriction and shivering. It often also produces a lower body sympathectomy that provokes a core to peripheral redistribution of body heat. It is difficult to treat the core to peripheral redistribution of body heat. However redistribution can be prevented by preanesthetic cutaneous warming. Prewarming hardly changes core temperature that remains well regulated, but it markedly increases peripheral tissue heat content. As a result, prewarming reduces the core to peripheral tissue temperature gradient and the propensity for redistribution after the induction of anesthesia.

We therefore hypothesized that Combined modality active warming consisting of preoperative 15 min of surface warming using a forced air warmer before spinal anesthesia and coloading of warmed intravenous fluid might reduce perioperative hypothermia and shivering in women undergoing cesarean delivery. Additionally, We tested the hypothesis that maintaining maternal normothermia increases newborn temperature and Apgar scores.

Enrollment: 50 patients

Sex: Female

Ages: 20 to 45 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Patients scheduled for cesarean delivery under spinal anesthesia
• The American Society of Anesthesiologists physical status class one or two
• female between 20 and 45

Exclusion criteria

• Patients with heart disease
• Patients with infectious disease
• Patients with coagulopathy
• Patients with a drug allergy
• In case of switching to general anesthesia
• Patients BMI under 18.5 or over 31

Trial design

50 participants in 2 patient groups

Active warming

Description:

preoperative 15 min of surface warming using a forced air warmer before spinal anesthesia and coloading of warmed intravenous fluid

Treatment:

Behavioral: Prewarming using forced air warmer, warmed intravenous fluid

Control

Description:

no preoperative warming and room temperature intravenous fluid