The role of warmed intravenous fluid on intraoperative hypothermia and postoperative shivering during prolonged oral and maxillofacial surgery

Authors

  • Mohammad Emran Department of Anaesthesiology, Dhaka Dental College and Hospital, Dhaka, Bangladesh
  • Nur E. Dilara Islam Department of Anaesthesiology, Dhaka Dental College and Hospital, Dhaka, Bangladesh
  • M. Selim Sarker Department of Anaesthesiology, Dhaka Dental College and Hospital, Dhaka, Bangladesh
  • M. Mosaddak Akbar Department of Anaesthesiology, Dhaka Dental College and Hospital, Dhaka, Bangladesh
  • Mohammad Rezaul Karim Department of Anaesthesiology, Dhaka Dental College and Hospital, Dhaka, Bangladesh

DOI:

https://doi.org/10.18203/2320-6012.ijrms20232403

Keywords:

Hypothermia, Maxillofacial surgery, Shivering, Temperature

Abstract

Background: Under general anaesthesia, the core temperature may drop up to 6°C. Patients undergoing prolonged maxillofacial surgery frequently experience unintentional hypothermia that causes postanaesthetic shivering which is a common complication of anaesthesia that should be prevented. This study aimed to evaluate the role of warmed intravenous fluid in preventing intraoperative hypothermia and postoperative shivering.

Methods: Between January 2022 and December 2022, 322 patients with American Society of Anesthesiologists (ASA) physical status I, II and the age group of 18 to 45 years old scheduled for elective major oral and maxillofacial surgery were evaluated under the Department of Anaesthesiology in Dhaka Dental College and Hospital. The patients were grouped into Room Temperature Group and Warmed Fluid Group.

Results: 162 patients received warmed fluid, whereas 160 patients received fluid at room temperature. In Room Temperature Group, there were 89 male and 71 female patients, whereas Warmed Fluid group had 88 male and 74 female patients. At the end of the procedure, the basal core temperature was 36.7±0.2°C in the group receiving warmed fluid versus 35.9±0.2°C in the group receiving fluid at room temperature. The incidence of hypothermia (<36 °C) was much lower in Warmed Fluid Group (n=28, 17.28%) than Room Temperature Group (n=86, 53.75%). Shivering was more common in Room Temperature Group (n = 67, 41.86%) than in Warmed Fluid Group (n = 19, 11.73%) in the postanaesthetic care unit (PACU).

Conclusions: The results of this study suggested that intraoperative hypothermia and postoperative shivering are less common when warmed fluid is infused.

 

 

References

Brock N. Veterinary anaesthesia update. 2nd ed. Richmond, B.C.: Veterinary Anaesthesia Northwest, 2007:1-16, 2-19, 4-22.

Stepaniuk K, Brock, N. Anaesthesia monitoring in the dental and oral surgery patient. J Vet Dent. 2008;25(2):143-9.

Sessler DI. Mild perioperative hypothermia. N Engl J Med. 1997;336(24):1730-7.

Warttig S, Alderson P, Campbell G, Smith AF. Interventions for treating inadvertent postoperative hypothermia. Cochrane Database Syst Rev. 2014;11:CD009892.

Reynolds L, Beckmann J, Kurz A. Perioperative complications of hypothermia. Best Pract Res Clin Anaesthesiol. 2008;22(4):645-57.

Vaughan MS, Vaughan RW, Cork RC. Postoperative hypothennia in adults: Relationship of age, anaesthesia, and shivering to rewarming. Anesth Analg. 1981;60(10):746-51.

Morris RH, Wilkey BR. The effects of ambient temperature on patient temperature during surgery not involving body cavities. J Ame Soci Anesthesiol. 1970;32(2):102-7.

Morris RH. Influence of ambient temperature on patient temperature during intraabdominal surgery. Ann Surg .1971;173(2):230-3.

Morris RH. Operating room temperature and the anesthetized, paralyzed patient. Surg. 1971;102(2):95-7.

Cooper TE. Correlation of thermal properties of some human tissue with water content. Aerospace Med. 1971;42:24-7.

Orkin FK. Physiologic disturbances associated with induced hypothermia. Orkin FK, Cooperman LH-Complications in Anesthesiology. Philadelphia, JB Lippincott Company; 1983:626.

Sessler DI. Consequences and treatment of perioperative hypothermia. In: Levitt RC ed. Anesthesiology Clinics of North America. Philadelphia: WB Saunders Company; 1994:425- 456.

Garg M, Cascarini L, Coombes DM, Walsh S, Tsarouchi D, Bentley R, et al. Multicentre study of operating time and inpatient stay for orthognathic surgery. Br J Oral Maxillofac Surg. 2010;48(5):360-3.

Thomas AA, Rittersma J. Anaesthetic experiences in orthodontic surgery. J Maxillofacial Surg. 1978;6:204-6.

Sessler DI, Warner DS, Warner MA. Temperature monitoring and perioperative thermoregulation. J Am Soci Anesthesiol. 2008;109(2):318-38.

Park SM, Mangat HS, Berger K, Rosengart AJ. Efficacy spectrum of antishivering medications: Meta-analysis of randomized controlled trials. Crit Care Med. 2012;40(11):3070-82.

Eberhart LH, Döderlein F, Eisenhardt G, Kranke P, Sessler DI, Torossian A, et al. Independent risk factors for postoperative shivering. Anesth Analg 2005;101(6):849-57.

Hoshijima H, Takeuchi R, Kuratani N, Nishizawa S, Denawa Y, Shiga T, et al. Incidence of postoperative shivering comparing remifentanil with other opioids: a meta-analysis. J Clin Anesth. 2016;32:300-12.

Ramanathan NL. A new weighting system for mean surface temperature of the human body. Appl Physiol. 1964;19(3):531-3.

Bilotta F, Pietropaoli P, La Rosa I, Spinelli F, Rosa G. Effects of shivering prevention on haemodynamic and metabolic demands in hypothermic postoperative neurosurgical patients. Anaesth. 2001;56(6):519.

Burton AC. Human calorimetry. 11: The average temperature of the tissues of the body. Nutr. 1935;9(3):261-80.

Colin J, Timbal J, Houdas Y, Boutelier C, Guieu JD. Computation of mean body temperature from rectal and skin temperatures. Appl Physiol. 1971;31(3):484-9.

Kongsayreepong S, Chaibundit C, Chadpaibool J, Komoltri C, Suraseranivongse S, Suwannanonda P, et al. Predictor of core hypothermia and the surgical intensive care unit. Anesth Analg. 2003;96(3):826-33.

Stepaniuk K, Brock N. Hypothermia and thermoregulation during anaesthesia for the dental and oral surgery patient. J Veter Dentis. 2008;25(4):279-83.

Putzu M, Casati A, Berti M, Pagliarini G, Fanelli G. Clinical complications, monitoring and management of perioperative mild hypothermia: anesthesiological features. Acta Bio-Med At Parm. 2007;78(3):163-9.

Macario A, Dexter, F. What are the most important risk factors for a patient's developing intraoperative hypothermia? Anesth Analg. 2002;94(1):215-20.

Henneberg S, Eklund A, Joachimsson PO, Stjernström H, Wiklund L. Effects of a thermal ceiling on postoperative hypothermia. Acta anaesthesiologica scandinavica. 1985;29(6):602-6.

Camus Y, Delva E, Cohen S, Lienhart A. The effects of warming intravenous fluids on intraoperative hypothermia and postoperative shivering during prolonged abdominal surgery. Acta Anaesthesiologica Scandinavica. 1996;40(7):779-82.

Frank SM, Fleisher LA, Breslow MJ, Higgins MS, Olson KF, Kelly S, et al. Perioperative maintenance of normothermia reduces the incidence of morbid cardiac events. A randomized clinical trial. JAMA. 1997;277(14):1127-34.

Kurz A, Sessler DI, Lenhardt R. Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. Study of Wound Infection and Temperature Group. N Engl J Med. 1996;334(19):1209-15.

White PF, Kehlet H, Neal JM, Schricker T, Carr DB, Carli F, et al. The role of the anesthesiologist in fast-track surgery: from multimodal analgesia to perioperative medical care. Anesth Analg. 2007;104(6):1380-96.

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Published

2023-07-29

How to Cite

Emran, M., Dilara Islam, N. E., Sarker, M. S., Akbar, M. M., & Karim, M. R. (2023). The role of warmed intravenous fluid on intraoperative hypothermia and postoperative shivering during prolonged oral and maxillofacial surgery. International Journal of Research in Medical Sciences, 11(8), 2774–2779. https://doi.org/10.18203/2320-6012.ijrms20232403

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Original Research Articles