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Prevention of intraoperative hypothermia during laparoscopic surgery of long duration: A-147

Campos, J. M.; Piñol, S.; Remartínez, F.; Casas, J. I.

European Journal of Anaesthesiology: May 2005 - Volume 22 - Issue - p 40–41
Ambulatory Anaesthesia
Free
SDC

Department of Anesthesia, Hospital Sant Pau, Barcelona, Spain

Background and Goal of Study: Laparoscopic surgery (L.S.) as a result of CO2 pneumoperitoneum induces intraoperative hypothermia. This is a significant source of morbidity (1), with potential sequelae: cardiovascular (vasoconstriction) and higher incidence of postoperative infection (2). Our aim was to examine the degree of hypothermia and the efficacy of air warming blankets in preventing it during L.S. of long duration (>2 hours).

Materials and Methods: We randomized 30 patients scheduled for L.S.: hemicolectomy, anterior rectum resection, splenectomy, and Nissen operation. Four patients were excluded (change to laparotomy). [Control group (G-C) 12 pts protected with the usual surgical drapes. Group Bair-Hugger (G-B) 14 pts covered before anesthesia induction with air warming blanket on thorax and the arm exposed]. Both groups received perfusions warmed by HotlineTM. We collected pharyngeal temperature (core T) and operating room T from induction every 30 min until the end of procedure.

Results and Discussion: There were not statistically differences between variable's groups: Age, body mass index, volume infusions, surgical time. Evolutions of T are shown in the Table (Mean ± SD).

Table

Table

The use of air warming blankets kept all the pts of group B normothermic (>36°C). It is very important to protect the patient before anesthesia induction in order to prevent the initial loss of core T as a result of redistribution of body T.

Conclusions: Laparoscopic surgery induces intraoperative hypothermia as open surgery does. Normotermia can be maintained efficiently using air warming blankets, a safe and not expensive technique. The use of these devices also increases the operating room T at the end of surgery, as a “collateral” protective action.

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References:

1 Nduka CC. Surg Endosc 2002; 16:611-5.
2 Kurz A. NEJM 1996; 334:1209-15.
© 2005 European Society of Anaesthesiology