Preoperative Warming and Perioperative Shivering

Study Overview
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Brief Summary
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Shivering is one of the most commonly recognized problem associated with anesthesia, It is believed to be thermoregulatory in origin. Studies suggest that pre-warming the patient prior to the surgery can reduce the chances of hypothermia induced shivering during the post operative period. Forced air warmers are the most frequently used active warming devices in the peri-operative setting. Currently, our hospital does not pre-warm patients but if our study shows that pre-warming reduces post-operative shivering, we will be able to make an evidence based decision to start this practice.

Detailed Description
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Inadvertent peri-operative hypothermia (IPH) and shivering is one of the most commonly recognized problem during anesthesia which is believed to be thermoregulatory in origin. Although shivering is uncomfortable for most patients, it is unlikely that this relatively small increase in total body oxygen consumption in the average shivering patient is associated with increased peri-operative morbidity. It is common for patients to complain that their worst memory from the recovery room is the intense cold sensation and uncontrollable shivering. New guidelines recommend that patients core temperature has to be maintained at >36°C, postoperatively. Studies suggest that pre-warming the patient prior to the surgery can reduce the chances of hypothermia induced shivering during the post operative period. Forced air warmers are the most frequently used active warming devices in the peri-operative setting. They are effective at preventing hypothermia induced shivering when used before induction of anesthesia, during anesthesia and surgery, and after emergence in the post-anesthesia care unit. Other methods such as warm fluids, opioids, blankets and warm light devices can be used but are less effective as compared to the forced air warming devices. Currently, our hospital does not pre-warm patients but if our study shows that pre-warming reduces post-operative shivering, we will be able to make an evidence based decision to start this practice.

Official Title
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Effectiveness of Pre-operative Warming in Prevention of Peri-operative Shivering

Conditions
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Forced Air Warming Effect on Hypothermia

Intervention / Treatment
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* Device: Forced Air Warmer
* Other: No pre-op warming


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All patients going under therapeutic laparoscopic surgery All patients between 15-70 years irrespective of their gender ASA 1-3 patients Those who have given informed consent Exclusion Criteria: Any patient undergoing diagnostic laparoscopic surgery Patients below age of 15 yrs ASA 4 or higher patients Patients not giving informed consent

Ages Eligible for Study
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Minimum Age: 15 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: No pre-op warming<br>No pre-warming in bay before surgery. | Other: No pre-op warming<br>* No forced air warming of the patient prior to being taken in for surgery<br>|
| Active Comparator: Pre-op forced air warming<br>A forced air warmer device (WarmTouch Convective Warming System) will be used to pre-warm patients in holding bay before surgery | Device: Forced Air Warmer<br>* A forced air warmer device will be used to pre-warm patients for 10 minutes in holding bay before surgery. Air warming device is an electrically powered control unit, hose, and inflatable blanket. The control unit has an air filter and heater, which warms air entrained from the environment. The hose connects to a blanket.<br>* Other names: Forced air warmer (FAW);|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| inadvertent shivering post surgery | number of patients who experience shivering in holding bay | upto 2-3 hours post-surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Shivering, Hypothermia, Postoperative, Temperature, Forced air warmer