Comparison of Two Different Uses of Underbody Forced-air Warming Blankets for the Prevention of Hypothermia in Patients Undergoing Arthroscopic Shoulder Surgery: a Prospective Randomized Study
Abstract Background: Forced-air warming (FAW) is an effective method of preventing inadvertent perioperative hypothermia (IPH). However, its warming effects can be influenced by the style and position of the FAW blanket. This study aimed to compare the effects of underbody FAW blankets being placed under or over patients in preventing IPH.Methods: Patients (n=100) undergoing elective arthroscopic shoulder surgery in the lateral decubitus position were randomized into either under body (UB) group or the over body (OB) group (50 per group). The core body temperature (CBT) of the patients was recorded from baseline to the end of anesthesia. The incidences of postoperative hypothermia and shivering were also collected.Results: A steady decline in the CBT was observed in both groups up to 60 minutes after the start of FAW. After 60 minutes of warming, the OB group showed a gradual increase in the CBT. However, the CBT still decreased in UB group until 75 minutes, with a low of 35.7℃ ± 0.4℃. Then the CBT increased mildly and reached 35.8℃ ± 0.4℃ at 90 minutes. After 45 minutes of warming, the CBT was significantly different (P < 0.05). The incidence of postoperative hypothermia in the UB group was significantly higher than that in the OB group (P = 0.023).Conclusions: The CBT was significantly better when the underbody FAW blanket was placed over patients compared with under the patients. However, there was not a clinically significant difference in CBT. The incidence of postoperative hypothermia was much lower in the OB group. Therefore, placing underbody FAW blankets over patients is recommended for the prevention of IPH in patients undergoing arthroscopic shoulder surgery.Trial registration: This single-center, prospective, RCT has completed the registration of the Chinese Clinical Trial Center at 13/1/2021 with the registration number ChiCTR2100042071. It was conducted from 14/1/2021 to 30/10/2021 as a single, blinded trial in Sichuan Provincial Orthopedic Hospital.