The Effect of Preoperative Active Warming on Intraoperative Body Temperature
Condition: Total Knee Arthroplasty; Intraoperative Hypothermia
MeSH terms: Hypothermia
Study type: Interventional

Summary: 
      A randomized controlled study was conducted to examine the effect of active warming before
      total knee arthroplasty on intraoperative body temperature and comfort.
    

Detailed description: 
      Inadvertent perioperative hypothermia is defined as a patient's internal temperature below 36
      °C in surgical settings. All patients undergoing surgery and other invasive procedures are at
      risk of developing undesirable hypothermia. Both general and neuraxial anesthesia greatly
      impair thermoregulatory control, and as a result, unwarmed surgical patients become
      hypothermic. General and regional anesthesia causes undesirable hypothermia as a result of
      the redistribution of body temperature from the center to the periphery.

      In the perioperative period, patients over 60 years of age with poor nutritional status, low
      core temperature before surgery, preoperative fasting and fluid deprivation before
      anesthesia, premedication, type of surgery, dry and cold anesthetic gases, cold intravenous
      fluids, flushes, blood products (cold fluids direct core temperature) Hypothermia is caused
      by low ambient temperature, wet skin, dressings or sheets, anesthetic agents, large open
      cavity or abdominal surgery, excessive blood loss, drugs used before surgery.

      There are many methods to maintain the body temperature of patients (passive isolation
      methods) or to warm the patient (active warming methods). Passive insulation methods include
      heated cotton blankets, surgical drapes, and thermal suits. Active heating techniques include
      compressed air heaters, electric heating blankets, and heated liquids and gases.

      In the literature, studies on active and passive heating methods have been found in order to
      prevent undesirable hypothermia. There are studies with stand-alone active heating methods
      (such as pressurized hot air blowing systems, heated liquids, circulating hot water systems)
      and combined methods. Because the results of these studies were different, a randomized
      controlled study was planned to investigate the effectiveness of the prewarming intervention,
      to support the surgical process nurses in clinical practice, and to increase the reliability
      of the results, before developing a procedure related to prewarming.

      In the study, the effect of prewarming with a hot air blowing system before the surgical
      procedure on the patients who will undergo total knee arthroplasty, on the patient's body
      temperature during the operation and on the comfort in the early postoperative period will be
      determined.
    

Intervention name(s): Prewarming
Intervention type(s): Device
Intervention description(s): When patients in the study group come to the Preoperative Care Unit (PCU), their body temperature will be measured. Patients in the study group will be placed in such a way that the 3M™ Bair Hugger™ Whole Body Blanket covers the patient's body and prewarmed with the 3M™ Bair Hugger™ Warming Unit for 30 minutes before anesthesia is given in the PCU. Heating unit temperature will be adjusted to 43°C in line with company recommendations. After the patients in the study group are warmed up for 30 minutes, the preheating process will be completed and the whole body blanket will be taken and the blankets that the clinic routinely use for each patient will be covered to cover the patients' body.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Patients were divided into intervention and control groups using the block randomization method.
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: Surgical nursing; Inadvertent hypothermia; Perioperative period; Active warming; Comfort