In the fixed effect model , the warming group had significantly less pain and lower incidence of wound infection , compared with the no-warming group .
In the r and om effect model , the warming group was also associated with lower risk of post-anesthetic shivering .
Both in the r and om and the fixed effect models , the warming group was associated with significantly less blood loss .
Perioperative warming of surgical patients is effective in reducing postoperative wound pain , wound infection and shivering .
Systemic warming of the surgical patient is also associated with less perioperative blood loss through preventing hypothermia-induced coagulopathy .
OBJECTIVE The objective of this review was to systematic ally analyze the trials on the effectiveness of perioperative warming in surgical patients .
Unintentional Hypothermia Is Associated with Postoperative Myocardial Ischemia
Background Hypothermia occurs commonly during surgery and can be associated with increased metabolic dem and s during rewarming in the postoperative period . Although cardiac complications remain the leading cause of morbidity after anesthesia and surgery , the relationship between unintentional hypothermia and myocardial ischemia during the perioperative period has not been studied . Methods One hundred patients undergoing lower extremity vascular reconstruction received continuous Hotter monitoring throughout the first 24 h postoperatively . Myocardial ischemia was determined by a cardiologist masked to clinical variables . The patient 's sublingual temperature on arrival at the intensive care unit immediately after the surgical procedure was used to divide the patients into two groups : hypothermic ( temperature , < 35 ° C ; n = 33 ) and normothermic ( temperature , ≤ 35 ° C ; n = 67 ) . The relationship between unintentional hypothermia and myocardial ischemia occurring during the first postoperative day was evaluated by univariate and multivariate analyses . Results A greater percentage of patients had electrocardiographic changes consistent with myocardial ischemia in the hypothermic group ( 36 % , 12 of 33 ) compared with those in the normothermic group ( 13 % , 9 of 67 , P = 0.008 ) . Preoperative risk factors for perioperative cardiac morbidity were similar between the two groups , except for patient age . The mean age was 70 ± 2 yr and 62 ± 1 yr in the hypothermic and normothermic groups , respectively ( P = 0.001 ) . When subgroup and multivariate analyses were used to adjust for differences in age , temperature remained an independent predictor of ischemia ( odds ratio , 1.82 per degree Celsius ; 95 % confidence interval , 1.09–3.02 ) . The incidence of postoperative angina was greater in the hypothermic group ( 18 % , 6 of 33 ) than in the normothermic group ( 1.5 % , 1 of 67 , P = 0.002 ) . The incidence of PaO2 < 80 mmHg in the arterial blood was greater in the hypothermic group ( 52 % , 17 of 33 ) than in the normothermic group ( 30 % , 20 of 67 , P = 0.03 ) . Conclusions Unintentional hypothermia is associated with myocardial ischemia , angina , and PaO2 < 80 mmHg during the early postoperative period in patients undergoing lower extremity vascular surgery
In the fixed effect model , the warming group had significantly less pain and lower incidence of wound infection , compared with the no-warming group .
In the r and om effect model , the warming group was also associated with lower risk of post-anesthetic shivering .
Both in the r and om and the fixed effect models , the warming group was associated with significantly less blood loss .
Perioperative warming of surgical patients is effective in reducing postoperative wound pain , wound infection and shivering .
Systemic warming of the surgical patient is also associated with less perioperative blood loss through preventing hypothermia-induced coagulopathy .
OBJECTIVE The objective of this review was to systematic ally analyze the trials on the effectiveness of perioperative warming in surgical patients .