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The effects of pre-induction warming on preoperative anxiety in surgery patients: A-20

Kimberger, O.; Sonnleitner, C.; Illievich, U.; Lenhardt, R.

European Journal of Anaesthesiology: May 2005 - Volume 22 - Issue - p 6
Evidence Based Practice and Quality Assurance

Department of Anesthesiology and General Intensive Care, Medical University of Vienna, Wien, Austria

Background and Goal of Study: Active warming of patients is not only able to improve thermal comfort, but has also been shown to reduce anxiety in a prehospital setting (1). We compared the efficacy of active warming with forced air in the preoperative holding area with passive insulation and/or midazolam.

Materials and Methods: 80 patients were randomized in 4 groups in the preoperative holding area:

  1. passive insulation and placebo;
  2. passive insulation and midazolam (30 μg/kg);
  3. active warming with forced air and placebo;
  4. active warming with forced air and midazolam (30 μg/kg).

After an initial set of measurements the designated treatment was instituted, a second set of measurements was performed in the OR, right before induction of anesthesia (30-45 min later). Thermal comfort and anxiety levels were assessed with VAS 0-100 (0 intense cold/no anxiety; 100 intense heat/severe anxiety) and patients' anxiety was additionally measured with the Spielberger State-Trait Anxiety Inventory (STAI).

Results and Discussions:




  1. Prewarming with forced air provides better thermal comfort in the preoperative area.
  2. It does not reduce preoperative anxiety adequately in comparison to midazolam.
  3. A combination of prewarming and midazolam can be recommended.
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1 Kober A. Mayo Clin Proc 2001; 76: 369-375.
© 2005 European Society of Anaesthesiology