Korean J Anesthesiol.  2012 May;62(5):454-460. 10.4097/kjae.2012.62.5.454.

Effect of preoperative warming during cesarean section under spinal anesthesia

• Chung SH
• Lee BS
• Yang HJ
• Kweon KS
• Kim HH
• Song J
• Shin DW

• KMID: 2243825
• DOI: http://doi.org/10.4097/kjae.2012.62.5.454

Abstract

BACKGROUND
Postoperative hypothermia and shivering is a frequent event in patients during cesarean section under spinal anesthesia. We assessed the effect of preoperative warming during cesarean delivery under spinal anesthesia for prevention of hypothermia and shivering.
METHODS
Forty five patients undergoing elective cesarean section were randomly assigned to three groups. Group F received warmed intravenous fluid (40degrees C). Group A patients were actively warmed by forced air-warming. Group C was the control group. Forced air-warming and warmed fluid was maintained for the 15 min preceding spinal anesthesia. Core temperature (tympanic membrane) and the skin temperature of arm and thigh were measured and shivering was graded simultaneously.
RESULTS
The core temperature at 45 min decreased less in Groups F and A than Group C (-0.5degrees C +/- 0.3degrees C vs -0.6degrees C +/- 0.4degrees C vs -0.9degrees C +/- 0.4degrees C, respectively; P = 0.004). The arm temperature at 15 min and 30 min exhibited a greater increase in Group A than Group F and Group C (P = 0.001 and P = 0.012, respectively). Leg temperature increased similarly among the three groups. The incidence of shivering was significantly less in Group A and Group F than Group C (20%, 13.3%, and 53.3%, respectively; P = 0.035).
CONCLUSIONS
Preoperative forced air-warming and warmed fluid prevents hypothermia and shivering in patients undergoing elective cesarean delivery with spinal anesthesia.

Keyword

Cesarean section; Shivering; Spinal anesthesia; Warming

MeSH Terms

Anesthesia, Spinal
Arm
Cesarean Section
Female
Humans
Hypothermia
Incidence
Leg
Pregnancy
Shivering
Skin Temperature
Thigh