Perioperative warming with a thermal gown prevents maternal temperature loss during elective cesarean section. A randomized clinical trial

Abstract

Background and objectives Decrease in body temperature is common during general and regional anesthesia. Forced-air warming intraoperative during cesarean section under spinal anesthesia seems not able to prevent it. The hypothesis considers that active warming before the intraoperative period avoids temperature loss during cesarean. Methods Forty healthy pregnant patients undergoing elective cesarean section with spinal anesthesia received active warming from a thermal gown in the preoperative care unit 30 min before spinal anesthesia and during surgery (Go, n = 20), or no active warming at any time (Ct, n = 20). After induction of spinal anesthesia, the thermal gown was replaced over the chest and upper limbs and maintained throughout study. Room temperature, hemoglobin saturation, heart rate, arterial pressure, and tympanic body temperature were registered 30 min before (baseline) spinal anesthesia, right after it (time zero) and every 15 min thereafter. Results There was no difference for temperature at baseline, but they were significant throughout the study (p < 0.0001; repeated measure ANCOVA). Tympanic temperature baseline was 36.6 +/- 0.3 degreeC, measured 36.5 +/- 0.3 degreeC at time zero and reached 36.1 +/- 0.2 degreeC for gown group, while control group had baseline temperature of 36.4 +/- 0.4 degreeC, measured 36.3 +/- 0.3 degreeC at time zero and reached 35.4 +/- 0.4 degreeC (F = 32.53; 95% CI 0.45-0.86; p < 0.001). Hemodynamics did not differ throughout the study for both groups of patients. Conclusion Active warming 30 min before spinal anesthesia and during surgery prevented a fall in body temperature in full-term pregnant women during elective cesarean delivery. Copyright © 2015 Sociedade Brasileira de Anestesiologia