The effectiveness of prewarming for patients under spinal anaesthesia in oncogynecological surgery


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Abstract

Inadvertent perioperative hypothermia (IPH) occurs in many patients, undergoing oncogynecological operations, due to the influence of the spinal anesthesia and sedation. The conventional intraoperative using of forced-air warming is insufficient to counteract thermal redistribution resulting from the peripheral vasodilatation, associated with spinal anesthesia. The objective of the study was to test the efficiency of the preoperative forced-air warming device (Bair Hugger) in combination with intravenous injection of tramadol in preventing IPH. Material and Methods. Eighty adult patients undergoing oncogynecological surgery under spinal anesthesia (SA) were randomized to receive either normal care or prewarming for 30 min, at 43°C, using the Bair Hugger, in combination with the injection of tramadol preoperatively. Results. Forty patients were prewarmed and received tramadol (0,5 mg/kg) and 40 patients were in the control group. There was smaller decrease in mean core temperature in the prewarmed group at 15, 30, 75, 90 min post-induction (p < 0,05). By the end of the operation all patients from the control group remained hypothermic, whereas only 28 patients (70%) remained hypothermic in prewarmed group (P < 0,05). 26 (65%) patients from the control group and 10 (25%) patients in prewarmed group suffered from muscle shivering (P < 0,05). There were no significant differences in vomiting and nausea between the groups. Conclusions. Preoperative warming using the Bair Hugger, combined with preoperative injection of tramadol results in smaller decreases in core temperature intraoperatively and less IPH in patients undergoing oncogynecological surgery under SA.

About the authors

Artur V. Pasheev

Kazan state medical academy; Republican cancer center

Email: artur.pasheev@yandex.ru
MD, PhD, assistant of Department of anesthesiology and reanimatology of Kazan State Medical Academy, anesthesiologist of the Department of anesthesiology and intensive care № 2 of the Republican Cancer center 420012, Kazan, Russian Federation

A. K Sayetgaraev

Kazan state medical academy; Republican cancer center

420012, Kazan, Russian Federation

G. Sh Muftahutdinova

Republican cancer center

420029, Kazan, Russian Federation

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