Zohaib Akhtar1, Brian D Hesler2, Alexa N Fiffick3, Edward J Mascha4, Daniel I Sessler5, Andrea Kurz6, Sabry Ayad7, Leif Saager8. 1. Clinical Research Fellow, Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH. 2. Research Staff, Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH. 3. Research Assistant, Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH. 4. Associate Staff of Biostatistics, Departments of Quantitative Health Sciences, Lerner Research Institute and Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH. 5. Professor and Chair, Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH. 6. Professor and Vice-Chair, Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH; Chair, Department of General Anesthesia, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH. 7. Clinical Associate Professor and Chair, Fairview Hospital, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH. 8. Associate Professor, Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH. Electronic address: saagerl@ccf.org.
Abstract
STUDY OBJECTIVE: To test the primary hypothesis that forced-air prewarming improves patient satisfaction after outpatient surgery and to evaluate the effect on core temperature and thermal comfort. DESIGN: Prospective randomized controlled trial. SETTING: Preoperative area, operating room, and postanesthesia care unit. PATIENTS: A total of 115 patients aged 18 to 75 years with American Society of Anesthesiologists status <4 and body mass index of 15 to 36kg/m(2) who were undergoing outpatient surgery (duration <4 hours). INTERVENTIONS: Patients were randomized to active prewarming with a Mistral-Air warming system initially set to 43°C or no active prewarming. All patients were warmed intraoperatively. MEASUREMENTS: Demographic and morphometric characteristics, perioperative core temperature, ambient temperature, EVAN-G satisfaction score, thermal comfort via visual analog scales. MAIN RESULTS: Data from 102 patients were included in the final analysis. Prewarming did not significantly reduce redistribution hypothermia, with prewarmed minus not prewarmed core temperature differing by only 0.18°C (95% confidence interval [CI], -0.001 to 0.37) during the initial hour of anesthesia (P=.052). Prewarming increased the mean EVAN-G satisfaction score, although not significantly, with an overall difference (prewarmed minus not prewarmed) of 5.6 (95% CI, -0.9 to 12.2; P=.09). Prewarming increased thermal comfort, with an overall difference of 6.6 mm (95% CI, 1.0-12.9; P=.02). CONCLUSION: Active prewarming increased thermal comfort but did not significantly reduce redistribution hypothermia or improve postoperative patient satisfaction.
RCT Entities:
STUDY OBJECTIVE: To test the primary hypothesis that forced-air prewarming improves patient satisfaction after outpatient surgery and to evaluate the effect on core temperature and thermal comfort. DESIGN: Prospective randomized controlled trial. SETTING: Preoperative area, operating room, and postanesthesia care unit. PATIENTS: A total of 115 patients aged 18 to 75 years with American Society of Anesthesiologists status <4 and body mass index of 15 to 36kg/m(2) who were undergoing outpatient surgery (duration <4 hours). INTERVENTIONS:Patients were randomized to active prewarming with a Mistral-Air warming system initially set to 43°C or no active prewarming. All patients were warmed intraoperatively. MEASUREMENTS: Demographic and morphometric characteristics, perioperative core temperature, ambient temperature, EVAN-G satisfaction score, thermal comfort via visual analog scales. MAIN RESULTS: Data from 102 patients were included in the final analysis. Prewarming did not significantly reduce redistribution hypothermia, with prewarmed minus not prewarmed core temperature differing by only 0.18°C (95% confidence interval [CI], -0.001 to 0.37) during the initial hour of anesthesia (P=.052). Prewarming increased the mean EVAN-G satisfaction score, although not significantly, with an overall difference (prewarmed minus not prewarmed) of 5.6 (95% CI, -0.9 to 12.2; P=.09). Prewarming increased thermal comfort, with an overall difference of 6.6 mm (95% CI, 1.0-12.9; P=.02). CONCLUSION: Active prewarming increased thermal comfort but did not significantly reduce redistribution hypothermia or improve postoperative patient satisfaction.
Authors: Kaitlyn T Bailey; Sanket R Jantre; Frank R Lawrence; F Claire Hankenson; Jacquelyn M Del Valle Journal: J Am Assoc Lab Anim Sci Date: 2022-08-31 Impact factor: 1.706
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