title: Preventing hypothermia in elective arthroscopic shoulder surgery patients: a protocol for a randomised controlled trial.
abstract: BACKGROUND
  Patients having arthroscopic shoulder surgery frequently experience periods of inadvertent hypothermia. This common perioperative problem has been linked to adverse patient outcomes such as myocardial ischaemia, surgical site infection and coagulopathy. International perioperative guidelines recommend patient warming, using a forced air warming device, and the use of warmed intraoperative irrigation solutions for the prevention of hypothermia in at-risk patient groups. This trial will investigate the effect of these interventions on patients' temperature, thermal comfort, and total recovery time.
  
  
  METHODS
  The trial will employ a randomised 2 x 2 factorial design. Eligible patients will be stratified by anaesthetist and block randomised into one of four groups: Group one will receive preoperative warming with a forced air warming device; group two will receive warmed intraoperative irrigation solutions; group three will receive both preoperative warming and warmed intraoperative irrigation solutions; and group four will receive neither intervention. Participants in all four groups will receive active intraoperative warming with a forced air warming device. The primary outcome measures are postoperative temperature, thermal comfort, and total recovery time. Primary outcomes will undergo a two-way analysis of variance controlling for covariants such as operating room ambient temperature and volume of intraoperative irrigation solution.
  
  
  CONCLUSIONS
  This trial is designed to confirm the effectiveness of these interventions at maintaining perioperative normothermia and to evaluate if this translates into improved patient outcomes. AUSTRALIAN NEW ZEALAND CLINICAL TRIALS REGISTRY NUMBER: ACTRN12610000591055.
authors: St Vincent's Private Hospital, and Nursing Research Institute, St Vincent’s & Mater Health Sydney-Australian Catholic University, Victoria Street, Darlinghurst, NSW, 2010, Australia. jduff@stvincents.com.au
authors: Jed
authors: J
authors: Duff
authors: Renatta
authors: R
authors: Di Staso
authors: Kerry-Anne
authors: KA
authors: Cobbe
authors: Nicole
authors: N
authors: Draper
authors: Simon
authors: S
authors: Tan
authors: Emma
authors: E
authors: Halliday
authors: Sandy
authors: S
authors: Middleton
authors: Lawrence
authors: L
authors: Lam
authors: Kim
authors: K
authors: Walker
mesh_terms: D001182:Arthroscopy; D017558:Elective Surgical Procedures; D006358:Hot Temperature / Q000627:therapeutic use; D006801:Humans; D007035:Hypothermia / Q000517:prevention & control*; D007430:Intraoperative Care; D007431:Intraoperative Complications / Q000517:prevention & control*; D011300:Preoperative Care; D016032:Randomized Controlled Trials as Topic / Q000379:methods*; D012785:Shoulder Joint / Q000601:surgery*; D007507:Therapeutic Irrigation