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Evidence-based Practice and Quality Improvement

Prevention of perioperative hypothermia in transurethral resection under spinal anesthesia


Becerra, Á.; Cruz, R.; Suárez, V.; Betancor, V. D.; Hussein, Z.; Rodríguez, A.

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European Journal of Anaesthesiology (EJA): June 2013 - Volume 30 - Issue - p 19-20
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Background and Goal of Study: Hypothermia is a frequent complication during perioperative period. Its occurrence must be avoided in order to decrease morbidity/mortality and to increase patient satisfaction. During transurethral resection (TUR) considerable amounts of liquids at low temperature are used for bladder irrigation,bringing about a decrease in the core temperature of the patient.Moreover, spinal anesthesia causes hypothermia.

The aim of this study is to assess the effect of prewarming in the prevention of perioperative hypothermia during transurethral resection with spinal anesthesia

Materials and Methods: Once the approval of the Clinical Research Ethics Committee of our hospital was obtained, we carried out a prospective controlled study. Patients who underwent TUR under spinal anesthesia were collected for a period of 4 months. Patients were randomized into two groups: Group A, prophylaxis of perioperative hypothermia not carried out; Group B, prewarming with forced warm air applied. Data were analyzed using SPSS 15.0

Results and Discussion: One hundred thirty seven patients were included (88.3% men 11.7%women) with an average age of 70 (42-96) years old.The ASA physical status was ASA I: 4.4%, ASA II: 32.8%, ASA III: 54% and ASA IV: 8.8%. Both groups were comparable with regards to gender, age and ASA physical status.

75.9% of the patients were submitted to TUR for bladder cancer, while 24.1% were submitted to TURP. The average duration of the procedure was 34 (10-100) minutes. The average glycine infusion was 10.13 (1-34) liters. The average temperature of the operating room was 22.62 (21.6-24.2)°C. Patients arrived in the operating room with an average body temperature of 35.83 (34.7-37.1)°C.

54% of the patients were given prophylaxis for perioperative hypothermia through WarmTouch Mallinckrodt Medical device at 36-40°C, and 46% were not.

At the end of the procedure, the average temperature of Group B was 35.49°C (IC 95% 35.36-35.62) versus 35.07°C (IC 95% 34.92-35.23) for Group A. Therefore, there were statistically significant differences (p 0.02).

33% of Group A suffered from post-surgical shivering, versus 8.11% of Group B.

Conclusion: Preoperative prophylaxis with forced warm air prevents the occurence of perioperative hypothermia and post-surgical shivering in short duration transurethral resection under spinal anesthesia.

© 2013 European Society of Anaesthesiology