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Anesth Analg 2007; 105:1413-1419
© 2007 International Anesthesia Research Society
doi: 10.1213/01.ane.0000286167.96410.27
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OBSTETRIC ANESTHESIOLOGY

Intraoperative Forced Air-Warming During Cesarean Delivery Under Spinal Anesthesia Does Not Prevent Maternal Hypothermia

Alexander J. Butwick, MBBS, FRCA, Steven S. Lipman, MD, and Brendan Carvalho, MBBCh, FRCA

From the Department of Anesthesia, Stanford University School of Medicine, Stanford, California.

Address correspondence to Brendan Carvalho, MBBCh, FRCA, Department of Anesthesia, H3580, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA 94305. Address e-mail to bcarvalho{at}stanford.edu.

Abstract

BACKGROUND: Prewarming and intraoperative warming with forced air-warming systems prevent perioperative hypothermia and shivering in patients undergoing elective cesarean delivery with epidural anesthesia. We tested the hypothesis that intraoperative lower body forced air-warming prevents hypothermia in patients undergoing elective cesarean delivery with spinal anesthesia.

METHODS: Thirty healthy patients undergoing cesarean delivery with spinal anesthesia were randomly assigned to forced air-warming or control groups (identical cover applied with forced air-warming unit switched off). A blinded investigator assessed oral temperature, shivering, and thermal comfort scores at 15-min intervals until discharge from the postanesthetic care unit. Umbilical cord blood gases and Apgar scores were also measured after delivery.

RESULTS: The maximum core temperature changes were similar in the two groups (–1.3°C ± 0.4°C vs –1.3°C ± 0.3°C for the forced air-warming group and control group, respectively; P = 0.8). Core hypothermia (≤35.5°C) occurred in 8 of 15 patients receiving forced air-warming and in 10 of 15 unwarmed patients (P = 0.5). The incidence and severity of shivering did not significantly differ between groups. Umbilical cord blood gases and Apgar scores were similar in both groups (P = NS).

CONCLUSIONS: We conclude that intraoperative lower body forced air-warming does not prevent intraoperative hypothermia or shivering in women undergoing elective cesarean delivery with spinal anesthesia.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins and Stanford University Libraries' HighWire Press®. Copyright 2007 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2007 by the International Anesthesia Research Society.