The Effect of Warm Intravenous Fluid on Postoperative Pain: A Double-Blind Clinical Trial (original) (raw)
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Journal of Obstetric Anaesthesia and Critical Care, 2011
Maintenance of body temperature of obstetrical patients undergoing cesarean section is complicated by a variety of factors including heat loss to atmosphere, infusion of fluids at room temperature, disruption of thermoregulatory mechanisms by epidural or spinal anesthesia and redistribution hypothermia. Infusion of warm fluids is an important method of heat conservation. Hence, we evaluated the efficacy of intravenous fluid warming in preventing hypothermia by observing the change in core temperature with intravenous fluids at room temperature (22°C and 39°C) in patients undergoing lower segment cesarean section under spinal anesthesia. Materials and Methods: Sixty-four patients belonging to ASA grade I and II were randomly allocated to either of the two groups. Group I received intravenous fluids at room temperature (22ºC) and group II received intravenous fluids via fluid warmer (39ºC). Core temperature was recorded at every 1 min for the first 5 min, followed by 10 min till the end of surgery using a tympanic thermometer. Results: The mean decrease in core temperature in group I was -2.184 ± 0.413 and -1.934 ± 0.439 in group II. The comparison of group I and II showed a statistically significant difference in mean core temperatures at times 5, 50, 60, 70, 80 and 90 min and immediately on arrival in the recovery room. A lower incidence of shivering was seen in group II patients, but the difference in the two groups was not statistically significant. Conclusion: Infusion of warm intravenous fluids resulted in a lesser degree of fall in core temperature, thereby providing a significant temperature advantage; however, this did not translate to prevention of postoperative shivering.
Cooling for the reduction of postoperative pain: prospective randomized study
Hernia, 2006
Hernia surgery has been associated with severe pain within the first 24 h postoperatively. The application of cold or cryotherapy has been in use since at least the time of Hippocrates. The physiological and biological effects from the reduction of temperature in various tissues include local analgesia, inhibited oedema formation and reduced blood circulation. Our hypothesis was that cold therapy, applied by means of ice packs, following inguinal hernia surgery, controlled pain postoperatively. Forty patients scheduled for inguinal hernia repair were enrolled in a double-blind, randomized study. Postoperatively, chipped ice in a plastic bag (cold group), and a plastic bag containing only room temperature water (control) were placed over the incision for 20 min. Postoperative pain data were collected at 2, 6 and 24 h after operation according to the well validated visual analogue scale (VAS). The highest pain levels were recorded 2 h postoperatively for both groups. Pain levels then gradually decreased for both the trial groups during the first 24 h postoperatively. There were significant differences in the VAS scores between the groups at 2, 6 and 24 h. We conclude that local cooling is a safe and effective technique for providing analgesia following inguinal hernia repair.
Acta Anaesthesiologica Scandinavica, 1996
Background: The infusion of several liters of crystalloid solution at room temperature may significantly contribute to intraoperative hypothermia because warming fluid to core temperature requires body heat. The aim of this study was to evaluate the effect of delivering warmed intravenous (IV) fluid to the patient on preventing intraoperative hypothermia. Methods: lntraoperative core and mean skin temperatures were measured during prolonged abdominal surgery in 18 patients randomly divided into two groups according to intraoperative IV fluid management. In 9 patients (control group) all IV fluids infused were at room temperature. In the other 9 patients (group receiving warmed fluids) all IV fluids were warmed using an active IV fluid tube-warming system. In all 18 patients a warming blanket covered the skin surface available for cutaneous warming. Intraoperative changes in total body heat content (kJ) were calculated from core and mean skin temperatures.
Anaesthesia, 2010
We compared the effect of delivering fluid warmed using two methods in 76 adult patients having short duration surgery. All patients received a litre of crystalloid delivered either at room temperature, warmed using an in-line warming device or pre-warmed in a warming cabinet for at least 8 h. The tympanic temperature of those receiving fluid at room temperature was 0.4°C lower on arrival in recovery when compared with those receiving fluid from a warming cabinet (p = 0.008). Core temperature was below the hypothermic threshold of 36.0°C in seven (14%) patients receiving either type of warm fluid, compared to eight (32%) patients receiving fluid at room temperature (p = 0.03). The administration of 1 l warmed fluid to patients having short duration general anaesthesia results in higher postoperative temperatures. Pre-warmed fluid, administered within 30 min of its removal from a warming cabinet, is as efficient at preventing peri-operative hypothermia as that delivered through an in-line warming system.
Effect of heated and humidified carbon dioxide gas on core temperature and postoperative pain
Surgical Endoscopy, 2002
Background: Intraoperative hypothermia is a common event during laparoscopic operations. An external warming blanket has been shown to be eective in preventing hypothermia. It has now been proposed that using heated and humidi®ed insuation gas can prevent hypothermia and decrease postoperative pain. Therefore, we examined the extent of intraoperative hypothermia in patients undergoing laparoscopic Nissen fundoplication using an upper body warming blanket. We also attempted to determine whether using heated and humidi®ed insuation gas in addition to an external warming blanket would help to maintain intraoperative core temperature or decrease postoperative pain. Methods: Twenty patients were randomized to receive either standard carbon dioxide (CO 2) gas (control, n = 10) or heated and humidi®ed gas (heated and hu-midi®ed, n = 10). After the induction of anesthesia, an external warming blanket was placed on all patients in both groups. Intraoperative core temperature and intraabdominal temperature were measured at 15-min intervals. Postoperative pain intensity was assessed using a visual analogue pain scale, and the amount of analgesic consumption was recorded. Volume of gas delivered, number of lens-fogging episodes, intraoperative urine output, and hemodynamic data were also recorded. Results: There was no signi®cant dierence between the two groups in age, length of operation, or volume of CO 2 gas delivered. Compared with baseline value, mean core temperature increased by 0.4°C in the heated and humidi®ed group and by 0.3°C in the control group at 1.5 h after surgical incision. Intraabdominal temperature increased by 0.2°C in the heated and humidi®ed group but decreased by 0.5°C in the control group at 1.5 h after abdominal insuation. There was no signi®cant dierence between the two groups in visual analog pain scale (5.4 1.6 control vs 4.5 2.8 heated and hu-midi®ed), morphine consumed (27 26 mg control vs 32 19 mg heated and humidi®ed), urine output, lensfogging episodes, or hemodynamic parameters. Conclusion: Heated and humidi®ed gas, when used in addition to an external warming blanket, minimized the reduction of intraabdominal temperature but did not alter core temperature or reduce postoperative pain.
Ain-Shams Journal of Anesthesiology, 2023
Background Inadvertent perioperative hypothermia (IPH) defined as core temperature below 36.0 °C is a common complication of general anesthesia with prevalence up to 70%. Warming of peripheral tissues prior to induction of anesthesia reduces the central to peripheral temperature gradient, thereby minimizing central heat loss due to heat redistribution, after induction of anesthesia. This study aimed to evaluate the effect of prewarming on post-induction core temperature and incidence of perioperative inadvertent hypothermia leading to postanesthetic shivering (PAS) in patients undergoing general anesthesia. This is a single-arm study performed after authorization from the scientific review committee (IRB no.:10/2015/05) in a cohort of patients between the ages of 18 and 65 years in ASA I and II physical status, undergoing GA for elective surgeries lasting less than 3 h. Rates of IPH and PAS in 60 patients who were warmed before anesthesia over a 30-min period with a forced-air warmer set at 38.0 °C were compared with existing data from an equal number of cohorts who received only intraoperative warming, during similar surgical procedures according to routine GA. Comparisons between the two groups were made using the Student's t-test and chi-square test. A paired t-test or Wilcoxon's signed rank test was applied for pairwise comparisons. The results were considered statistically significant when the P-value was < 0.05. Results The mean decrease in core temperature in the unwarmed group was 0.7 °C (+ /-0.23) compared with a 0.2 °C decrease (+ /-0.06) in the prewarmed group of patients. A total of 31.70% of patients in the unwarmed group developed IPH compared with one patient (1.7%) in the prewarmed group shortly after onset. Twenty-six patients (43.30%) in the unwarmed group had hypothermia at the end of surgery, compared with one patient (1.7%) in the prewarmed group. Shivering was observed in 46% of patients in the unwarmed group, while no shivering was observed in the prewarmed group. Conclusions Preoperative warming is an effective intervention to reduce the frequency of core temperature drops after induction of anesthesia, thereby preventing inadvertent perioperative hypothermia and the incidence of postoperative shivering.
Evaluation of the contribution to postoperative analgesia by local cooling of the wound
Anaesthesia, 1996
Thirty healthy patients undergoing lumbar spine surgery were randomly assigned to one of two groups .for postoperathie puin relief. Group I received morphine via patient controlled analgesia and local cooling of the wound by an externally applied cooling pad while group 2 received patient controlled analgesia alone. There M'US a signijicanr reduction in morphine consumption when local cooling was applied (18.6mg versus 30.2mg at IZh, 29.0mg iwrsus 49.6mg at 2411, p < 0.05). Patients were also signijicantlj1 more satisfied with their oi1erall postoperatiiw pain management when cooling therapy II'US used.
Effect of preoperative warming on intraoperative hypothermia: a randomized-controlled trial
Canadian journal of anaesthesia = Journal canadien d'anesthesie, 2018
The purpose of this study was to evaluate the effects of preoperative forced-air warming on intraoperative hypothermia. In this randomized-controlled trial, adult patients scheduled for elective, non-cardiac surgery under general anesthesia were stratified by scheduled surgical duration (< 2.5 hr or ≥ 2.5 hr) and then randomized to a pre-warming group using a BairPaws™ forced-air warming system for at least 30 min preoperatively or to a control group with warmed blankets on request. All patients were warmed intraoperatively via convective forced-air warming blankets. Perioperative temperature was measured using the SpotOn™ temperature system consisting of a single-use disposable sensor applied to the participant's forehead. The primary outcome was the magnitude of intraoperative hypothermia calculated as the area under the time-temperature curve for core temperatures < 36°C between induction of general anesthesia and leaving the operating room. Secondary outcomes included ...
International Journal of Research in Medical Sciences
Background: Under general anaesthesia, the core temperature may drop up to 6°C. Patients undergoing prolonged maxillofacial surgery frequently experience unintentional hypothermia that causes postanaesthetic shivering which is a common complication of anaesthesia that should be prevented. This study aimed to evaluate the role of warmed intravenous fluid in preventing intraoperative hypothermia and postoperative shivering. Methods: Between January 2022 and December 2022, 322 patients with American Society of Anesthesiologists (ASA) physical status I, II and the age group of 18 to 45 years old scheduled for elective major oral and maxillofacial surgery were evaluated under the Department of Anaesthesiology in Dhaka Dental College and Hospital. The patients were grouped into Room Temperature Group and Warmed Fluid Group. Results: 162 patients received warmed fluid, whereas 160 patients received fluid at room temperature. In Room Temperature Group, there were 89 male and 71 female patie...