Postoperative Complications Clinical Trial
Official title:
Prevention of Perioperative Hypothermia in Patients Submitted to Laparoscopic Urological Surgery
Hypothermia is a frequent perioperative complication. Its appearance can have deleterious
effects such as perioperative bleeding or surgical site infection. Once the temperature has
decreased, its treatment is difficult.
Preoperative warming prevents hypothermia, lowering the temperature gradient between core and
peripheral compartments and reducing thermal redistribution. The most recent clinical
practice guidelines advocate for active prewarming before induction of general anaesthesia
since it is very effective in preventing perioperative hypothermia. However, the ideal
warming time prior to the induction of anesthesia has long been investigated. This study aims
to evaluate if different time periods of preoperative forced-air warming reduces the
incidence of hypothermia at the end of surgery in patients submitted to laparoscopic
urological surgery under general anesthesia. This is an observational prospective study
comparing routine practice of pre-warming in consecutive surgical patients scheduled to
laparoscopic prostatectomy or nephrectomy between August and December 2018. In this study 64
- 96 patients will be included and prewarming will be applied following routine clinical
practice. The prewarming time will depend on the time the patient has to wait before entering
in the operating theatre. Measurement of temperature will be performed using an esophagic
thermometer. Patients will be followed throughout their hospital admission. Data will be
recorded using a validated instrument and will be analysed using the statistics program R
Core Team.
Maintaining patient's temperature above 36 grades Celsius throughout the perioperative period
is challenging. Thus, it is essential to monitor temperature in order to be able to take
measures to avoid the appearance of hypothermia. Once the temperature has decreased, its
treatment is difficult since the application of heat to the body surface takes a long time to
reach the core thermal compartment. Intraoperative warming alone cannot avoid postoperative
hypothermia. The application of forced-air warming system during the preoperative period has
been shown to be the most effective measure to prevent hypothermia and maintain
intraoperative normothermia. However, long time periods of prewarming would not be efficient.
Thus, the ideal warming time prior to the induction of anesthesia has long been investigated.
Due to the searching of optimal prewarming time, the conductance of this study is justified.
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