• Anesthesia and analgesia · Jun 2003

    Randomized Controlled Trial Comparative Study Clinical Trial

    Resistive-heating and forced-air warming are comparably effective.

    • Chiharu Negishi, Kenji Hasegawa, Shihoko Mukai, Fumitoshi Nakagawa, Makoto Ozaki, and Daniel I Sessler.
    • Department of Anesthesia, Tokyo Women's Medical University, Tokyo, Japan.
    • Anesth. Analg. 2003 Jun 1;96(6):1683-7, table of contents.

    UnlabelledSerious adverse outcomes from perioperative hypothermia are well documented. Consequently, intraoperative warming has become routine. We thus evaluated the efficacy of a novel, nondisposable carbon-fiber resistive-heating system. Twenty-four patients undergoing open abdominal surgery lasting approximately 4 h were randomly assigned to warming with 1) a full-length circulating water mattress set at 42 degrees C, 2) a lower-body forced-air cover with the blower set on high, or 3) a three-extremity carbon-fiber resistive-heating blanket set to 42 degrees C. Patients were anesthetized with a combination of continuous epidural and general anesthesia. All fluids were warmed to 37 degrees C, and ambient temperature was kept near 22 degrees C. Core (tympanic membrane) temperature changes among the groups were compared by using factorial analysis of variance and Scheffé F tests; results are presented as means +/- SD. Potential confounding factors did not differ significantly among the groups. In the first 2 h of surgery, core temperature decreased by 1.9 degrees C +/- 0.5 degrees C in the circulating-water group, 1.0 degrees C +/- 0.6 degrees C in the forced-air group, and 0.8 degrees C +/- 0.2 degrees C in the resistive-heating group. At the end of surgery, the decreases were 2.0 degrees C +/- 0.8 degrees C in the circulating-water group, 0.6 degrees C +/- 1.0 degrees C in the forced-air group, and 0.5 degrees C +/- 0.4 degrees C in the resistive-heating group. Core temperature decreases were significantly greater in the circulating-water group at all times after 150 elapsed minutes; however, temperature changes in the forced-air and resistive-heating groups never differed significantly. Even during major abdominal surgery, resistive heating maintains core temperature as effectively as forced air.ImplicationsEfficacy was similar for forced-air and resistive heating, and both maintained intraoperative core temperature far better than circulating-water mattresses. We thus conclude that even during major abdominal surgery, resistive heating maintains core temperature as effectively as forced air.

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