Comparison of Forced Air Warming with Warm Intravenous Fluid Versus Forced Air Warming Alone in Preventing Hypothermia and Shivering in Obstetric Patients

Shujaat Hussain; Syed Qasim  Ali Shah; Hassam  Abdullah; Saddam  Hussain; Taffazal  Mehdi; Najam ul  Hassan

doi:10.51253/pafmj.v76iSUPPL-5.11677

Authors

Shujaat Hussain Department of Anesthesia, Combined Military Hospital, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Syed Qasim Ali Shah Department of Anesthesia, Combined Military Hospital, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Hassam Abdullah Department of Anesthesia, Combined Military Hospital, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Saddam Hussain Department of Anesthesia, Combined Military Hospital, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Taffazal Mehdi Department of Anesthesia, Combined Military Hospital, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Najam ul Hassan Department of Anesthesia, Combined Military Hospital, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v76iSUPPL-5.11677

Keywords:

Body Temperature, Caesarian Section, Hypothermia, Intravenous fluid, Shivering, Warm

Abstract

Objective: To compare methods of forced air warming combined with warm intravenous fluid administration versus forced air warming alone in preventing hypothermia and shivering associated with spinal anesthesia for elective caesarian section.

Study Design: Randomized controlled trial (IRCT number iRCT20231022059809N1).

Place and Duration of Study: Department of Anesthesia, Combined Military Hospital Rawalpindi, Pakistan from May to Nov 2023.

Methodology: The patients were randomized into Group FWI (forced warming with warm IV fluid) and FWA (forced warming alone). Primary variables measured were core body temperature in both groups’ pre-spinal, 30 and 60 minutes into the procedure and then at 30- and 60-minute intervals in the PACU post-procedure. Secondary variable measured was incidence of shivering during the procedure and in the recovery.

Results: Core body temperature measured in degrees Celsius between Group FWI and Group FWA was 37.34±0.17 degrees Celsius versus 37.34±0.16 degrees Celsius measured pre-spinal administration (p=0.922). It was 36.85±0.09 degrees Celsius versus 36.12±0.10 degrees Celsius 30 minutes after spinal during the procedure between both groups (p<0.001) and was 36.84±0.09 degrees Celsius versus 36.11±0.10 degrees Celsius measured 60 minutes in the procedure between both groups (p<0.001)

Conclusion: We conclude that addition of warm intravenous fluid with forced air warming maintains better core body temperature, decreases hypothermia and incidence of shivering both per-operatively and in the recovery.

Downloads

Download data is not yet available.

References

Betran AP, Ye J, Moller A-B, Souza JP, Zhang J. Trends and projections of caesarean section rates: global and regional estimates. BMJ Glob Health 2021; 6(6): e005671.

https://doi.org/10.1136/bmjgh-2021-005671

2. Tollånes MC. Increased rate of Caesarean sections--causes and consequences. Tidsskrift for den Norske lægeforening: tidsskrift for praktisk medicin, ny række 2009; 129(13): 1329-1331.

https://doi.org/10.4045/tidsskr.08.0453

3. Binici O, Büyükfırat E. Anesthesia for cesarean section in parturients with abnormal placentation: a retrospective study. Cureus 2019; 11(6).

https://doi.org:10.7759/cureus.5033

4. Ahmed F, Chithrala B, Barve K, Biladeau S, Clifford S. Value-Based Care in Anesthesia. Cureus 2023; 15(8): e44410.

https://doi.org/10.7759/cureus.44410

5. Iddrisu M, Khan ZH. Anesthesia for cesarean delivery: general or regional anesthesia—a systematic review. Ain-Shams J Anesthesiol 2021; 13(1): 1-7.

https://doi.org/10.1186/s42077-020-00121-7

6. Watson SE, Richardson AL, Lucas DN. Neuraxial and general anaesthesia for caesarean section. Best Pract Res Clin Anaesthesiol 2022; 36(1): 53-68.

https://doi.org/10.1016/j.bpa.2022.04.007

7. Omar H, Aboella WA, Hassan MM, Hassan A, Hassan P, Elshall A, et al. Comparative study between intrathecal dexmedetomidine and intrathecal magnesium sulfate for the prevention of post-spinal anaesthesia shivering in uroscopic surgery;(RCT). BMC Anesthesiol 2019; 19(1): 1-10.

https://doi.org/10.1186/s12871-019-0853-0

8. Feng G, Wang Y, Feng J, Luo X, Li C, Yao S. The relationship between core temperature and perioperative shivering during caesarean section under intrathecal anesthesia with bupivacaine and ropivacaine: a randomized controlled study. J Anesth 2021; 35(6): 889-895. https://doi.org/10.1007/s00540-021-02995-9

9. Mendonça FT, Ferreira JdS, Guilardi VHF, Guimarães GMN. Prevalence of inadvertent perioperative hypothermia and associated factors: a cross-sectional study. Ther Hypothermia Temp Manag 2021; 11(4): 208-215.

https://doi.org/10.1089/ther.2020.0038

10. Simegn GD, Bayable SD, Fetene MB. Prevention and management of perioperative hypothermia in adult elective surgical patients: a systematic review. Ann Med Surg 2021; 72: 103059. https://doi.org/10.1016/j.amsu.2021.103059

11. Meghana V, Vasudevarao SB, Kamath SS. The effect of combination of warm intravenous fluid infusion and forced air warming versus forced air warming alone on maternal temperature and shivering during cesarian delivery under spinal anesthesia. Ann Afr Med 2020; 19(2): 137.

https://doi.org/10.4103%2Faam.aam_58_19

12. Abbas SA, Hamadani SM, Ahmad U, Desai A, Kitchloo K. Ophthalmic timolol and hospitalization for symptomatic bradycardia and syncope: a case series. Cureus 2020; 12(3): e7270. https://doi.org/10.7759/cureus.7270

13. Cai J, Tang M, Wu H, Yuan J, Liang H, Wu X, et al. Association of intraoperative hypotension and severe postoperative complications during non-cardiac surgery in adult patients: A systematic review and meta-analysis. Heliyon 2023; 9(5): e15997.

https://doi.org/10.1016/j.heliyon.2023.e15997

14. Dendis M, Hooven K. Preventing hypothermia during cesarean birth: an integrative review. MCN: Am J Matern Child Nurs 2020; 45(2): 102-108.

https://doi.org/10.1097/nmc.0000000000000599

15. Jun J-H, Chung MH, Jun I-J, Kim Y, Kim H, Kim JH, et al. Efficacy of forced-air warming and warmed intravenous fluid for prevention of hypothermia and shivering during caesarean delivery under spinal anaesthesia: A randomised controlled trial. Eur J Anaesthesiol 2019; 36(6): 442-448.

https://doi.org/10.1097/eja.0000000000000990

16. Chen W-A, Liu C-C, Mnisi Z, Chen C-Y, Kang Y-N. Warming strategies for preventing hypothermia and shivering during cesarean section: A systematic review with network meta-analysis of randomized clinical trials. Int J Surg 2019; 71: 21-28.

https://doi.org/10.1016/j.ijsu.2019.09.006

17. Marin L, Hocker J, Esser A, Terhorst R, Sauerwald A, Schroder S. Forced-air warming and continuous core temperature monitoring with zero-heat-flux thermometry during cesarean section: a retrospective observational cohort study. Braz J Anesthesiol 2022; 72: 484-492.

https://doi.org/10.1016/j.bjane.2021.10.007

18. Ni T-t, Zhou Z-f, He B, Zhou Q-h. Effects of combined warmed preoperative forced-air and warmed perioperative intravenous fluids on maternal temperature during cesarean section: a prospective, randomized, controlled clinical trial. BMC Anesthesiol 2020; 20(1): 1-8.

https://doi.org/10.1186/s12871-020-00970-7

19. Golmohammadi M, Karami N, Tahmasebi R. Incidence of Shivering During Cesarean Section in Patients Under Spinal Anesthesia With or Without Fentanyl. Int J Pharm Clin Res 2020; 31(6): 423-432.

20. Rasoli S, Ansari E, Moslemi F, Ghojazadeh M. The Prophylactic Administration of Intravenous Paracetamol for Control of Shivering During and After Cesarean Section Under Spinal Anesthesia. Arch Anesthesiol Crit Care 2019; 5(2): 38-40.

https://doi.org/10.18502/aacc.v5i2.748