title: [Perioperative warming with a thermal gown prevents maternal temperature loss during elective cesarean section. A randomized clinical trial].
abstract: OBJECTIVE
  Decrease in body temperature is common during general and regional anesthesia. Forced-air warming intraoperative during cesarean section under spinal anesthesia seems not able to prevent it. The hypothesis considers that active warming before the intraoperative period avoids temperature loss during cesarean.
  
  
  METHODS
  Forty healthy pregnant patients undergoing elective cesarean section with spinal anesthesia received active warming from a thermal gown in the preoperative care unit 30min before spinal anesthesia and during surgery (Go, n=20), or no active warming at any time (Ct, n=20). After induction of spinal anesthesia, the thermal gown was replaced over the chest and upper limbs and maintained throughout study. Room temperature, hemoglobin saturation, heart rate, arterial pressure, and tympanic body temperature were registered 30min before (baseline) spinal anesthesia, right after it (time zero) and every 15min thereafter.
  
  
  RESULTS
  There was no difference for temperature at baseline, but they were significant throughout the study (p<0.0001; repeated measure ANCOVA). Tympanic temperature baseline was 36.6±0.3°C, measured 36.5±0.3°C at time zero and reached 36.1±0.2°C for gown group, while control group had baseline temperature of 36.4±0.4°C, measured 36.3±0.3°C at time zero and reached 35.4±0.4°C (F=32.53; 95% CI 0.45-0.86; p<0.001). Hemodynamics did not differ throughout the study for both groups of patients.
  
  
  CONCLUSIONS
  Active warming 30min before spinal anesthesia and during surgery prevented a fall in body temperature in full-term pregnant women during elective cesarean delivery.
authors.affiliation: Hospital Central da Irmandade da Santa Casa de Misericórdia de Sao Paulo, São Paulo, SP, Brasil.
authors.forename: Ricardo Caio Gracco de
authors.initials: RC
authors.lastname: Bernardis
authors.affiliation: Hospital Central da Irmandade da Santa Casa de Misericórdia de Sao Paulo, São Paulo, SP, Brasil.
authors.forename: Monica Maria
authors.initials: MM
authors.lastname: Siaulys
authors.affiliation: Departamento de Cirurgia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil. Electronic address: joaquimev@usp.br.
authors.forename: Joaquim Edson
authors.initials: JE
authors.lastname: Vieira
authors.affiliation: Departamento de Cirurgia, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brasil.
authors.forename: Lígia Andrade Silva Telles
authors.initials: LA
authors.lastname: Mathias
keywords: Anestesia; Anesthesia; Body temperature; Cesarean section; Cesariana; Complicações no intraoperatório/prevenção e controle; Cuidados no perioperatório; Espinhal; Intraoperative complications/prevention and control; Perioperative care; Spinal; Temperatura corporal