Effect of prewarmimg on body temperature and shivering in total knee arthroplasty patients after surgery

Authors

  • Ratchanee Sukanthachalathon Faculty of Nursing, Mahidol University, Bangkok, Thailand
  • Usavadee Asdornwised Faculty of Nursing, Mahidol University, Bangkok, Thailand
  • Orapan Thosingha Faculty of Nursing, Mahidol University, Bangkok, Thailand
  • Phongthara Vichitvejpaisal Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

Keywords:

Prewarming, body temperature, shivering, total knee arthroplasty surgery

Abstract

Background: Inadvertent hypothermia and shivering is recognized risk in surgery. Core temperature in patients warmed with forced air warming remains poorly characterized. The incidence in patients with total knee arthroplasty (TKA) leading to intraoperative hypothermia 43.9%.

Objectives: This quasi-experimental research study was conducted to compare body temperature and shivering after surgery in patients with total knee arthroplasty who received prewarming and those who received routine nursing care.

Methods: Thirty-first patients were randomly assigned for experimental group and Thirty-first patients for control group. Data were collected by the following tools and methods, namely: patient demographic and clinical characteristic records, tympanic membrane thermometer, ambient temperature and humidity meter and the wrench’s scale. Data were analyzed by using One-way analysis of covariance (ANCOVA) to compare the differences between the means of body temperature both groups and shivering was analyzed by Chi-square test.

Results: Body temperature in the experimental group was higher than the control group at the time before discharged from the operating room (P < 0.001), at the time they entered the recovery room (P = 0.001) and at 30 minutes after they transferred to the recovery room (P < 0.001) and 60 minutes after they transferred to the recovery room (P = 0.001). The means of body temperature before returning to the recovery room of both groups were not significantly different (P = 0.391). In addition, the shivering in the experimental group was significantly lower than the control group at time that entered to the recovery room (P = 0.009) and at 30 minutes after transferred to the recovery room (P = 0.002). The means temperature at 60 minutes after transferred to the recovery room the experimental group and control group were not significant difference (P = 0.1).

Conclusion: Prewarming was more effective than not prewarming in the prevention of postoperative hypothermia and shivering in TKA.

Downloads

Download data is not yet available.

References

Bashaw MA. Guideline implementation: Preventing hypothermia. Aorn J 2016;103:305-10.

https://doi.org/10.1016/j.aorn.2016.01.009

Ratanatherawichian Y, Asdornwised U, Thongkam N, Kanlayanakoop K. Incidence and predictive factor of postoperative hypothermia of patients in PostAnesthesia Care Unit (PACU). J Nurs Sci 2014;31:34-44.

Frisch NB, Pepper AM, Rooney E, Silverton C. Intraoperative hypothermia in total hip and knee arthroplasty. Orthopedics 2017;40:56-63. https://doi.org/10.3928/01477447-20161017-04

Sharma M, Kharbuja K, Khadka B. Comparison of pethidine and tramadol for the control of shivering in patients undergoing elective surgery under spinal anesthesia. J Lumbini Med Coll 2016;4:64-7.

https://doi.org/10.22502/jlmc.v4i2.92

Kurnat-Thoma EL, Roberts MM, Corcoran EB. Perioperative heat loss prevention-a feasibility trial. Aorn J 2016;104:307-19. https://doi.org/10.1016/j.aorn.2016.07.012

Billeter AT, Hohmann SF, Druen D, Cannon R, Polk HC, Jr. Unintentional perioperative hypothermia is associated with severe complications and high mortality in elective operations. Surgery 2014;156:1245-52. https://doi.org/10.1016/j.surg.2014.04.024

Sessler DI. Temperature monitoring: the consequences and prevention of mild perioperative hypothermia. SAJAA 2014;20:25-31. https://doi.org/10.1080/22201173.2014.10844560

Koenen M, Passey M, Rolfe M. Keeping them warm-a randomized controlled trial of two passive perioperative warming methods. J Perianesth Nurs 2017;32:188-98.

https://doi.org/10.1016/j.jopan.2015.09.011

Diaz M, Becker DE. Thermoregulation: Physiological and clinical considerations during sedation and general anesthesia. Anesth Prog 2010;57:25-32. https://doi.org/10.2344/0003-3006-57.1.25

Torossian A, Brauer A, Hocker J, Bein B, Wulf H, Horn E-P. Preventing inadvertent perioperative hypothermia. Dtsch Arztebl Int 2015;112:166-72. https://doi.org/10.3238/arztebl.2015.0166

Kishore N, Payal YS, Kumar N, Chauhan N. In spinal anaesthesia for cesarean section the temperature of bupivacaine affects the onset of shivering but not the incidence: A randomized control trial. J Clin Diagn Res 2016;10:Uc18-21. https://doi.org/10.7860/JCDR/2016/15883.7118

Nicholson M. A comparison of warming interventions on the temperatures of inpatients undergoing colorectal surgery. Aorn J 2013;97:310-22. https://doi.org/10.1016/j.aorn.2012.12.018

Roberson MC, Dieckmann LS, Rodriguez RE, Austin PN. A review of the evidence for active preoperative warming of adults undergoing general anesthesia. Aana J 2013;81:351-6.

Horn EP, Bein B, Bohm R, Steinfath M, Sahili N, Hocker J. The effect of short time periods of preoperative warming in the prevention of peri-operative hypothermia. Anaesthesia 2012;67:612-7.

https://doi.org/10.1111/j.1365-2044.2012.07073.x

Paulikas CA. Prevention of unplanned perioperative hypothermia. Aorn J 2008;88:358-65.

https://doi.org/10.1016/j.aorn.2008.05.020

Kellam MD, Dieckmann LS, Austin PN. Forced-air warming devices and the risk of surgical site infections. Aorn J 2013;98:354-66. https://doi.org/10.1016/j.aorn.2013.08.001

Alderson P, Campbell G, Smith AF, Warttig S, Nicholson A, Lewis SR. Thermal insulation for preventing inadvertent perioperative hypothermia. Cochrane Database Syst Rev 2014: Cd009908.

https://doi.org/10.1002/14651858.CD009908.pub2

McSwain JR, Wolf BJ, Wilson SH. Neuraxial hypothermia incidence misinterpreted. J Clin Anesth 2017;40:125. https://doi.org/10.1016/j.jclinane.2017.05.009

Rosenkilde C, Vamosi M, Lauridsen JT, Hasfeldt D. Efficacy of prewarming with a self-warming blanket for the prevention of unintended perioperative hypothermia in patients undergoing hip or knee arthroplasty. J Perianesth Nurs 2017;32:419-28. https://doi.org/10.1016/j.jopan.2016.02.007

Horosz B, Malec-Milewska M. Inadvertent intraoperative hypothermia. Anaesthesiol Intensive Ther 2013;45:38-43. https://doi.org/10.5603/AIT.2013.0009

Maniar A, Koh KF. Heat balance and anaesthetic implications in the elderly. In: Dodds C, Kumar CM, Veering BT, editors. Oxford textbook of anaesthesia for the elderly patient. New York: Oxford University Press; 2014. p. 280-87. https://doi.org/10.1093/med/9780199604999.003.0034

Pei L, Huang Y, Xu Y, Zheng Y, Sang X, Zhou X, et al. Effects of ambient temperature and forced-air warming on intraoperative core temperature: A factorial randomized trial. Anesthesiology 2018;128:903-11. https://doi.org/10.1097/ALN.0000000000002099

Muensakul S, Kunsongkeit W, Deenan A. Effects of warming program on core temperature and shivering among women receiving cesarean section under spinal anesthesia. J Fac Nurs Burapha Univ 2013;21:62-73.

De Bernardis RC, Siaulys MM, Vieira JE, Mathias LA. Perioperative warming with a thermal gown prevents maternal temperature loss during elective cesarean section. A randomized clinical trial. Braz J Anesthesiol 2016;66:451-5. https://doi.org/10.1016/j.bjane.2014.12.007

Shin KM, Ahn JH, Kim IS, Lee JY, Kang SS, Hong SJ, et al. The efficacy of pre-warming on reducing intraprocedural hypothermia in endovascular coiling of cerebral aneurysms. BMC Anesthesiol 2015;15:8.

https://doi.org/10.1186/1471-2253-15-8

Horn EP, Bein B, Broch O, Iden T, Bohm R, Latz SK, et al. Warming before and after epidural block before general anaesthesia for major abdominal surgery prevents perioperative hypothermia: A randomized controlled trial. Eur J Anaesthesiol 2016;33:334-40.

https://doi.org/10.1097/EJA.0000000000000369

Yang L, Huang CY, Zhou ZB, Wen ZS, Zhang GR, Liu KX, et al. Risk factors for hypothermia in patients under general anesthesia: Is there a drawback of laminar airflow operating rooms? A prospective cohort study. Int J Surg 2015;21:14-7. https://doi.org/10.1016/j.ijsu.2015.06.079

Downloads

Published

2023-07-19

How to Cite

1.
Sukanthachalathon R, Asdornwised U, Thosingha O, Vichitvejpaisal P. Effect of prewarmimg on body temperature and shivering in total knee arthroplasty patients after surgery. Chula Med J [Internet]. 2023 Jul. 19 [cited 2024 Dec. 22];65(3). Available from: https://he05.tci-thaijo.org/index.php/CMJ/article/view/144