scholarly journals Warm and humidified insufflation gas during gynecologic laparoscopic surgery reduces postoperative pain in predisposed patients—a randomized, controlled multi-arm trial

2021 ◽  
Author(s):  
Markus Breuer ◽  
Julia Wittenborn ◽  
Rolf Rossaint ◽  
Julia Van Waesberghe ◽  
Ana Kowark ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Recovery Room ◽  
Abdominal Pressure ◽  
Randomized Controlled ◽  
Parallel Group ◽  
Forced Air Warming ◽  
Warming Blanket ◽  
Lower Pain ◽  
Gynecologic Laparoscopy ◽  
Forced Air

Abstract Background Postoperative pain remains a common problem in gynecologic laparoscopy, especially in head zone-related regions, triggered by intra-abdominal pressure during capnoperitoneum. Humidified and prewarmed insufflation gas may ameliorate pain and be beneficial. Methods This prospective randomized controlled parallel group multi-arm single-center study investigated the effects of temperature and humidity of insufflation gas on postoperative pain during gynecologic laparoscopy with a duration ≥ 60 min. Female participants (18—70 years) were blinded and randomly assigned—computer generated—to either insufflation with dry cold CO2 with forced air warming blanket (“AIR”), humidified warm gas without forced air warming blanket (“HUMI”), or humidified warm gas with forced air warming blanket (“HUMI +”). We hypothesized that using humidified warm gas resulted in lower pain scores and less analgesic consumption. The primary endpoint postoperative pain was assessed for different pain localizations every 12 h during 7 days after surgery. Secondary endpoints were demand for painkillers and epidural anesthetics, length of stay in recovery room, and hospital stay. (Registration: ClinicalTrials.gov NCT02781194—completed). Results 150 participants were randomized. Compared to group “AIR” (n = 48), there was significantly less pain in group “HUMI +” (n = 48) in the recovery room (− 1.068; 95% CI − 2.08 to − 0.061), as well as significantly less ibuprofen use at day two (− 0.5871 g ± 0.258; p-value = 0.0471). Other variables did not change significantly. Stratification for presence of endometriosis or non-previous abdominal surgery in patient history revealed significantly less pain in both groups “HUMI” (n = 50) and “HUMI +” versus group “AIR.” Related side effects were not noted. Conclusion In the overall population, the use of warm, humidified insufflation gas did not yield clinically relevant effects; however, in predisposed patients with endometriosis and who could otherwise expect high pain levels, warm and humidified gas may be beneficial.

scholarly journals Optimal Application of Forced Air Warming to Prevent Peri-Operative Hypothermia during Abdominal Surgery: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 18 (5) ◽  
pp. 2517
Author(s):  
Yoonyoung Lee ◽  
Kisook Kim
Keyword(s):  
Systematic Review ◽  
Abdominal Surgery ◽  
Critical Appraisal ◽  
Meta Analysis ◽  
Upper Body ◽  
Cochrane Library ◽  
Randomized Controlled ◽  
Forced Air Warming ◽  
Forced Air ◽  
Full Body

Patients who undergo abdominal surgery under general anesthesia develop hypothermia in 80–90% of the cases within an hour after induction of anesthesia. Side effects include shivering, bleeding, and infection at the surgical site. However, the surgical team applies forced air warming to prevent peri-operative hypothermia, but these methods are insufficient. This study aimed to confirm the optimal application method of forced air warming (FAW) intervention for the prevention of peri-operative hypothermia during abdominal surgery. A systematic review and meta-analysis were conducted to provide a synthesized and critical appraisal of the studies included. We used PubMed, EMBASE, CINAHL, and Cochrane Library CENTRAL to systematically search for randomized controlled trials published through March 2020. Twelve studies were systematically reviewed for FAW intervention. FAW intervention effectively prevented peri-operative hypothermia among patients undergoing both open abdominal and laparoscopic surgery. Statistically significant effect size could not be confirmed in cases of only pre- or peri-operative application. The upper body was the primary application area, rather than the lower or full body. These findings could contribute detailed standards and criteria that can be effectively applied in the clinical field performing abdominal surgery.

Warming With a Forced Air Warming Blanket Minimizes Anesthetic-Induced Hypothermia in Cats

1999 ◽  
Vol 28 (4) ◽  
pp. 301-310 ◽  
Author(s):  
Roslyn G. Machon ◽  
Marc R. Raffe ◽  
Elaine P. Robinson
Keyword(s):  
Induced Hypothermia ◽  
Forced Air Warming ◽  
Warming Blanket ◽  
Forced Air

Forced air-warming blanket versus pethidine for the prevention of shivering during and after caesarean section

2020 ◽  
Vol 7 (3) ◽  
pp. 260
Author(s):  
MohamedH Agamia ◽  
AhmedR Morsy ◽  
MervatM Abd Al-Maksod ◽  
RehabA Abd El Aziz
Keyword(s):  
Caesarean Section ◽  
Forced Air Warming ◽  
Warming Blanket ◽  
Forced Air

scholarly journals Induction techniques that reduce redistribution hypothermia: A prospective, randomized, controlled, single blind study.

2019 ◽  
Author(s):  
Jonathan Roth ◽  
Leonard E Braitman ◽  
Lacy H. Hunt
Keyword(s):  
Nitrous Oxide ◽  
Blind Study ◽  
Control Group ◽  
Randomized Controlled ◽  
Forced Air Warming ◽  
The Mean ◽  
Forced Air ◽  
Oxygen Group ◽  
Oxide Group ◽  
Single Blind

Abstract BACKGROUND While much effort has been devoted to correcting intraoperative hypothermia, less attention has been directed to preventing redistribution hypothermia. In this study, we compared three different induction techniques to standard IV propofol inductions (control) in their effect on reducing redistribution hypothermia. METHODS Elective, afebrile patients, age 18 to 55 years, were randomly assigned to one of four groups (n=50 each). Group “INH/100” was induced with 8% sevoflurane in 100% oxygen, Group “INH/50” with 8% sevoflurane in 50% oxygen and 50% nitrous oxide, Group “PROP” with 2.2 mg/kg propofol, and Group “Phnl/PROP” with 2.2 mg/kg propofol immediately preceded by 160 mcg phenylephrine. Patients were maintained with sevoflurane in 50% nitrous oxide and 50% oxygen in addition to opioid narcotic. Forced air warming was used. Core temperatures were recorded every 15 minutes after induction for one hour. (Inhalation inductions only were also studied in patients age >55 years.) RESULTS Compared to control group PROP, the mean temperatures in groups INH/100, INH/50, and Phnl/PROP were higher 15, 30, 45 and 60 minutes after induction (p<0.0001 for all comparisons), averaging between 0.39oC and 0.54oC higher. In group PROP, 60% of patients had at least one temperature below 36.0oC in the first hour whereas only 16% did in each of groups INH/100, INH/50, and Phnl/PROP (p<0.0001 in each group compared to PROP). (Inhalation inductions were also effective in reducing redistribution hypothermia in patients age >55 years.) CONCLUSIONS Inhalation inductions with sevoflurane or prophylactic phenylephrine bolus prior to propofol induction reduced the magnitude of redistribution hypothermia by an average of 0.4 to 0.5°C in patients aged 18 to 55 years. Registered on clinical-trials.gov as NCT02331108, November 20, 2014.

scholarly journals The Effect of Perioperative Vitamin C on Postoperative Analgesic Consumption: A Meta-Analysis of Randomized Controlled Trials

Nutrients ◽  
2020 ◽  
Vol 12 (10) ◽  
pp. 3109
Author(s):  
Kuo-Chuan Hung ◽  
Yao-Tsung Lin ◽  
Kee-Hsin Chen ◽  
Li-Kai Wang ◽  
Jen-Yin Chen ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Vitamin C ◽  
Randomized Controlled Trials ◽  
Pain Score ◽  
Meta Analysis ◽  
Morphine Consumption ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Lower Pain ◽  
Lower Pain Score

Because the analgesic effect of vitamin C against acute pain remains poorly addressed, this meta-analysis aimed at investigating its effectiveness against acute postoperative pain. A total of seven randomized controlled trials with placebo/normal controls were identified from PubMed, Cochrane Library, Medline, Google Scholar, and Embase databases. Pooled analysis showed a lower pain score (standardized mean difference (SMD) = −0.68, 95% CI: −1.01 to −0.36, p < 0.0001; I2 = 57%) and a lower morphine consumption (weighted mean difference (WMD) = −2.44 mg, 95% CI: −4.03 to −0.86, p = 0.003; I2 = 52%) in the vitamin group than that in the placebo group within postoperative 1–2 h. At postoperative 24 h, a lower pain score (SMD = −0.65, 95% CI: −1.11 to −0.19, p = 0.005; I2 = 81%) and lower morphine consumption (WMD = −6.74 mg, 95% CI: −9.63 to −3.84, p < 0.00001; I2 = 85%) were also noted in the vitamin group. Subgroup analyses demonstrated significant reductions in pain severity and morphine requirement immediately (1–2 h) and 24 h after surgery for patients receiving intravenous vitamin C but not in the oral subgroup. These findings showed significant reductions in pain score and opioid requirement up to postoperative 24 h, respectively, suggesting the effectiveness of perioperative vitamin C use. Further large-scale trials are warranted to elucidate its optimal intravenous dosage and effectiveness against chronic pain in the postoperative pain control setting.

Preoperative warming with a forced-air warming blanket prevents hypothermia during surgery

2018 ◽  
pp. e-65819
Author(s):  
Bjørg Eli Broback ◽  
Gjertrud Øvsthus Skutle ◽  
Elin Dysvik ◽  
Arild Eskeland
Keyword(s):  
Forced Air Warming ◽  
Warming Blanket ◽  
Forced Air

The Efficacy of a Resistive Heating Under-Patient Blanket Versus a Forced-Air Warming System: A Randomized Controlled Trial

2009 ◽  
Vol 108 (1) ◽  
pp. 199-201 ◽  
Author(s):  
Andrea Fanelli ◽  
Giorgio Danelli ◽  
Daniela Ghisi ◽  
Andrea Ortu ◽  
Elisa Moschini ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Resistive Heating ◽  
Randomized Controlled ◽  
System A ◽  
Forced Air Warming ◽  
Forced Air
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