Intraoperative forced air-warming during cesarean delivery under spinal anesthesia does not prevent maternal hypothermia.
BACKGROUND
Prewarming and intraoperative warming with forced air-warming systems prevent perioperative hypothermia and shivering in patients undergoing elective cesarean delivery with epidural anesthesia. We tested the hypothesis that intraoperative lower body forced air-warming prevents hypothermia in patients undergoing elective cesarean delivery with spinal anesthesia.


METHODS
Thirty healthy patients undergoing cesarean delivery with spinal anesthesia were randomly assigned to forced air-warming or control groups (identical cover applied with forced air-warming unit switched off). A blinded investigator assessed oral temperature, shivering, and thermal comfort scores at 15-min intervals until discharge from the postanesthetic care unit. Umbilical cord blood gases and Apgar scores were also measured after delivery.


RESULTS
The maximum core temperature changes were similar in the two groups (-1.3 degrees C +/- 0.4 degrees C vs -1.3 degrees C +/- 0.3 degrees C for the forced air-warming group and control group, respectively; P = 0.8). Core hypothermia (< or =35.5 degrees C) occurred in 8 of 15 patients receiving forced air-warming and in 10 of 15 unwarmed patients (P = 0.5). The incidence and severity of shivering did not significantly differ between groups. Umbilical cord blood gases and Apgar scores were similar in both groups (P = NS).


CONCLUSIONS
We conclude that intraoperative lower body forced air-warming does not prevent intraoperative hypothermia or shivering in women undergoing elective cesarean delivery with spinal anesthesia.
Butwick
Alexander J
AJ
Department of Anesthesia, Stanford University School of Medicine, Stanford, California 94305, USA.
Lipman
Steven S
SS
Carvalho
Brendan
B
D000293:Adolescent; D000328:Adult; D000775:Anesthesia, Spinal / Q000009:adverse effects* / Q000379:methods; D002585:Cesarean Section / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006358:Hot Temperature / Q000627:therapeutic use*; D006801:Humans; D007035:Hypothermia / Q000139:chemically induced / Q000517:prevention & control*; D007430:Intraoperative Care / Q000379:methods*; D007431:Intraoperative Complications / Q000139:chemically induced / Q000517:prevention & control*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012768:Shivering / Q000187:drug effects / Q000502:physiology