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