Comparison of upper and lower body forced air blanket to prevent perioperative hypothermia in patients who underwent spinal surgery in prone position: a randomized controlled trial

다국어 초록 (Multilingual Abstract)

Background: We compared upper- and lower-body forced-air blankets in terms of their ability to prevent perioperative hypothermia, defined as a reduction in body temperature to < 36.0°C, during the perioperative period in patients undergoing spine surgery in the prone position.Methods: In total, 120 patients scheduled for elective spine surgery under general anesthesia were divided into an upper-warming group (n = 60) and a lower-warming group (n = 60). After inducing anesthesia and preparing the patient for surgery, including prone positioning, the upper and lower bodies of the patients in the upper- and lower-warming groups, respectively, were warmed using a forced-air warmer with specified upper and lower blankets. Body temperature was measured using a tympanic membrane thermometer during the pre- and post-operative periods and using a nasopharyngeal temperature probe during the intraoperative period. Patients were evaluated in terms of shivering, thermal comfort, and satisfaction in the post-anesthesia care unit (PACU).Results: The incidence of intraoperative and postoperative hypothermia was lower in the upper-warming group than in the lower-warming group ([55.2% vs. 75.9%, P = 0.019] and [21.4% vs. 49.1%, P = 0.002]). Perioperative body temperature was higher in the upper-warming group (P < 0.001). However, intraoperative blood loss, postoperative thermal comfort scale and shivering scores, patient satisfaction, and PACU duration were similar in the two groups.Conclusions: The upper-body blanket was more effective than the lower-body blanket for preventing perioperative hypothermia in patients who underwent spine surgery in the prone position.

참고문헌 (Reference)

1 Lee LA, "The American Society of Anesthesiologists Postoperative Visual Loss Registry : analysis of 93 spine surgery cases with postoperative visual loss" 105 : 652-659, 2006

2 Nwaogu CJ, "Temperature and aridity determine body size conformity to Bergmann’s rule independent of latitudinal differences in a tropical environment" 159 : 1053-1062, 2018

3 Lynch S, "Reducing the risk of unplanned perioperative hypothermia" 92 : 553-562, 2010

4 Min SH, "Randomised trial comparing forced-air warming to the upper or lower body to prevent hypothermia during thoracoscopic surgery in the lateral decubitus position" 120 : 555-562, 2018

5 Young VL, "Prevention of perioperative hypothermia in plastic surgery" 26 : 551-571, 2006

6 Torossian A, "Preventing inadvertent perioperative hypothermia" 112 : 166-172, 2015

7 Li Y, "Prevalence and multivariable factors associated with inadvertent intraoperative hypothermia in video-assisted thoracoscopic surgery : a single-center retrospective study" 20 : 25-, 2020

8 Sessler DI, "Perioperative thermoregulation and heat balance" 387 : 2655-2664, 2016

9 Sessler DI, "Perioperative temperature monitoring" 134 : 111-118, 2021

10 Lee J, "Optimal nasopharyngeal temperature probe placement" 119 : 875-879, 2014

11 Yi J, "Incidence of inadvertent intraoperative hypothermia and its risk factors in patients undergoing general anesthesia in Beijing : a prospective regional survey" 10 : e0136136-, 2015

12 National Institute for Health Care Excellence, "Hypothermia: prevention and management in adults having surgery"

13 Yamakage M, "Evaluation of a forced-air warming system during spinal anesthesia" 9 : 93-95, 1995

14 Pasquier M, "Esophageal temperature measurement" 383 : e93-, 2020

15 Andrzejowski J, "Effect of prewarming on post-induction core temperature and the incidence of inadvertent perioperative hypothermia in patients undergoing general anaesthesia" 101 : 627-631, 2008

16 Sumida H, "Effect of forced-air warming by an underbody blanket on end-of-surgery hypothermia : a propensity score-matched analysis of 5063 patients" 19 : 50-, 2019

17 Buraimoh MA, "Effect of forced-air warming blanket position in elective lumbar spine surgery : intraoperative body temperature and postoperative complications" 10 : 229-, 2019

18 Horrow JC, "Does urinary catheter temperature reflect core temperature during cardiac surgery" 69 : 986-989, 1988

19 Motamed C, "Core and thenar skin temperature variation during prolonged abdominal surgery : comparison of two sites of active forced air warming" 44 : 249-254, 2000

20 Bräuer A, "Comparison of forced-air warming systems with upper body blankets using a copper manikin of the human body" 46 : 965-972, 2002

21 Bräuer A, "Comparison of forced-air warming systems with lower body blankets using a copper manikin of the human body" 47 : 58-64, 2003

22 Stein B, "Bronchospasm due to malpositioned esophageal temperature probe" 97 : 920-921, 2003

23 Asadian S, "Accuracy and precision of four common peripheral temperature measurement methods in intensive care patients" 9 : 301-308, 2016

24 이석수 ; 최은경 ; 권녕건 ; 김광범 ; 박상진, "Accidental cut of esophageal temperature probe during lobectomy for lung cancer - A case report -" 대한마취통증의학회 13 (13): 415-418, 2018