Pregnancy Clinical Trial
Official title:
Effects of Preanesthetic Forced Air Warming and Administration of Warmed Intravascular Fluid on Preventing Hypothermia and Shivering During Cesarean Delivery Under Spinal Anesthesia
The majority of women (> 60%) developed hypothermia and shivering during cesarean delivery.
Core hypothermia may be associated with a number of adverse outcomes in patients, including
shivering, wound infection, coagulopathy, increased blood loss and transfusion requirements,
decreased metabolism and prolonged recovery. Shivering can result in interference with
monitoring, increased tension on wound edges, and increased oxygen consumption.
A previous study has shown several modalities to prevent hypothermia and shivering in
patients undergoing cesarean delivery with spinal anesthesia. But, single modality
intervention have shown marginal or no efficacy.
Neuraxial anesthesia reduces the threshold for vasoconstriction and shivering. It often also
produces a lower body sympathectomy that provokes a core to peripheral redistribution of body
heat. It is difficult to treat the core to peripheral redistribution of body heat. However
redistribution can be prevented by preanesthetic cutaneous warming. Prewarming hardly changes
core temperature that remains well regulated, but it markedly increases peripheral tissue
heat content. As a result, prewarming reduces the core to peripheral tissue temperature
gradient and the propensity for redistribution after the induction of anesthesia.
We therefore hypothesized that Combined modality active warming consisting of preoperative 15
min of surface warming using a forced air warmer before spinal anesthesia and coloading of
warmed intravenous fluid might reduce perioperative hypothermia and shivering in women
undergoing cesarean delivery. Additionally, We tested the hypothesis that maintaining
maternal normothermia increases newborn temperature and Apgar scores.
n/a
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