1.Routine Intraoperative Forced-Air Warmer Usage in Prevention of Perioperative Hypothermia: To Use or Not to Use in Daycare Breast Lumpectomy?
Journal of Surgical Academia 2015;5(1):34-43
Intraoperative active warming in daycare surgery may be least popular compared to major elective surgeries due to
the lesser risk of perioperative hypothermia. This prospective, single blind, randomized, controlled trial in daycare
breast lumpectomy was done to evaluate the routine use of intraoperative forced-air warmer in the presence of other
warming modalities in prevention of perioperative hypothermia. Fifty patients were randomized into two groups;
Group 1 received forced-air warmer and Group 2 received a standard cotton thermal blanket. Both groups received
circulating-water mattress. Intraoperatively, all patients received pre-warmed intravenous fluid with an in-line
warmer. Ear and ambient temperature was recorded using infrared ear thermometer and digital thermo-hygrometer
respectively. Measurement was done before induction, every 15 minutes intraoperatively, upon arrival in recovery
room and 30 mins later, postoperatively. All patients were normothermic prior to induction of anaesthesia. During
the initial half an hour post-induction, both groups mean core temperature decreased at approximately 0.5˚C. Both
showed no statistical difference in mean core temperature (0.04 ˚C) within the initial half an hour. The next half an
hour, both groups had approximately 0.2˚C decrement but this time, Group 2 had a slightly higher mean core
temperature than Group 1 which maintained until the end of surgery. Overall, within the initial one hour postinduction
of GA, there was a drop of 0.7˚C and 0.6°C in Group 1 and Group 2 respectively, however the difference
in final mean core temperature between the two groups was 0.05°C and it was not statistically significant (p value <
0.05). None of the patients experienced intraoperative hypothermia (< 36˚C) and all remained in the normothermic
range with no shivering or sense of feeling cold, postoperatively. The results of the present study found no
significant difference in the changes of final core temperature with or without the usage of intraoperative forced-air
warmer in the presence of other warming measures in daycare breast lumpectomy.
Mastectomy, Segmental