J Dent Anesth Pain Med.  2015 Dec;15(4):193-200.

Clinical considerations in the use of forced-air warming blankets during orthognathic surgery to avoid postanesthetic shivering

• Park FD
• Park S
• Chi SI
• Kim HJ
• Seo KS
• Kim HJ
• Han JH
• Han HJ
• Lee EH

Abstract

BACKGROUND
During head and neck surgery including orthognathic surgery, mild intraoperative hypothermia occurs frequently. Hypothermia is associated with postanesthetic shivering, which may increase the risk of other postoperative complications. To improve intraoperative thermoregulation, devices such as forced-air warming blankets can be applied. This study aimed to evaluate the effect of supplemental forced-air warming blankets in preventing postanesthetic shivering.
METHODS
This retrospective study included 113 patients who underwent orthognathic surgery between March and September 2015. According to the active warming method utilized during surgery, patients were divided into two groups: Group W (n = 55), circulating-water mattress; and Group F (n = 58), circulating-water mattress and forced-air warming blanket. Surgical notes and anesthesia and recovery room records were evaluated.
RESULTS
Initial axillary temperatures did not significantly differ between groups (Group W = 35.9 ± 0.7℃, Group F = 35.8 ± 0.6℃). However, at the end of surgery, the temperatures in Group W were significantly lower than those in Group F (35.2 ± 0.5℃ and 36.2 ± 0.5℃, respectively, P = 0.04). The average body temperatures in Groups W and F were, respectively, 35.9 ± 0.5℃ and 36.2 ± 0.5℃ (P = 0.0001). In Group W, 24 patients (43.6%) experienced postanesthetic shivering, while in Group F, only 12 (20.7%) patients required treatment for postanesthetic shivering (P = 0.009, odds ratio = 0.333, 95% confidence interval: 0.147-0.772).
CONCLUSIONS
Additional use of forced-air warming blankets in orthognathic surgery was superior in maintaining normothermia and reduced the incidence of postanesthetic shivering.

Keyword

Circulating water mattress; Forced-air warming blanket; Intraoperative hypothermia; Postanesthetic shivering

MeSH Terms

Anesthesia
Body Temperature
Body Temperature Regulation
Head
Humans
Hypothermia
Incidence
Methods
Neck
Odds Ratio
Orthognathic Surgery*
Postoperative Complications
Recovery Room
Retrospective Studies
Shivering*

Figure

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  Fig. 1 Mean axillary temperature vs. time starting from induction of anesthesia. A, Group W with no experience of postanesthetic shivering; B, Group W with experience of postanesthetic shivering; C, Group F with no experience of postanesthetic shivering; D, Group F with experience of postanesthetic shivering. Data presented as mean with 5th-95th percentile. The mean temperature pattern for shivering and non-shivering groups resemble each other. The mean axillary temperature of Group F (C and D) was maintained above 36℃ during surgery whereas those in Group W (A and B) declined below 36℃.

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  Fig. 2 Number of patients who experienced postanesthetic shivering (P = 0.009, odds ratio = 0.333, 95% confidence interval: 0.147–0.772).

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  Fig. 3 Pethidine HCl injection administered in postanesthesia care unit (P = 0.002).

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