title: Are active warming measures required during paediatric cleft surgeries?
abstract: BACKGROUND
  During paediatric cleft surgeries intraoperative heat loss is minimal and hence undertaking all possible precautions available to prevent hypothermia and use of active warming measures may result in development of hyperthermia. This study aims to determine whether there will be hyperthermia on active warming and hypothermia if no active warming measures are undertaken. The rate of intraoperative temperature changes with and without active warming was also noted.
  
  
  METHODS
  This study was conducted on 120 paediatric patients undergoing cleft lip and palate surgeries. In Group A, forced air warming at 38°C was started after induction. In Group B, no active warming was done. Body temperature was recorded every 30 min starting after induction until 180 min or end of surgery. Intragroup comparison of variables was done using Paired sample test and intergroup comparison using independent sample t-test.
  
  
  RESULTS
  In Group A, all intraoperative temperature readings were significantly higher than baseline. In Group B, there was a significant reduction in temperature at 30 and 60 min. Temperature at 90 min did not show any significant difference, but further readings were significantly higher. Maximum rise in temperature occurred in Group A between 120 and 150 min and maximum fall in temperature in Group B was seen during first 30 min.
  
  
  CONCLUSIONS
  In pediatric cleft surgeries, we recommend active warming during the first 30 minutes if the surgery is expected to last for <2h, and no such measures are required if the expected duration is >2h.
authors.affiliation: Department of Anaesthesiology, Amrita Institute of Medical Sciences and Research Center, Kochi, Kerala, India.
authors.forename: Sunil
authors.initials: S
authors.lastname: Rajan
authors.forename: Kusuma Ramachandra
authors.initials: KR
authors.lastname: Halemani
authors.forename: Nitu
authors.initials: N
authors.lastname: Puthenveettil
authors.forename: Ramasubramanian
authors.initials: R
authors.lastname: Baalachandran
authors.forename: Priyanka
authors.initials: P
authors.lastname: Gotluru
authors.forename: Jerry
authors.initials: J
authors.lastname: Paul
keywords: Active warming; hyperthermia; hypothermia; paediatric cleft surgeries