EFFECT OF PREOPERATIVE WARMING DURING CESAREAN SECTION UNDER SPINAL ANESTHESIA

Background: Postoperative shivering, hypothermia and Surgical site infections (SSIs) are frequently encountered during Cesarean section (C section). Perioperative warming is a must for surgeries performed under spinal anesthesia, however its importance during C section is unclear. We assessed the functional outcomes of preoperative use of warmers and intravenous fluids (i.v) on parturients undergoing C section under spinal anesthesia.

Methods: 45 parturients undergoing an elective C section were randomized into three groups. Group D parturients received warmed i.v fluids (40°C). Group I parturients were given forced air warmers. Group V was the control group. Forced air warmers and i.v fluids were both administered for a period of 15 minutes before anesthetic induction. Core (tympanic membrane) and skin (under arm and thigh) temperatures were noted and shivering was graded.

Results: The Core temperature at 45 mins decreased less in Groups D and I than Group V (-0.5°C ± 0.3°C vs -0.6°C ± 0.4°C vs -0.9°C ± 0.4°C, respectively P = 0.004). The under arm temperature at 15 mins and 30 mins exhibited a greater increase in Group I than Group D and Group V (P = 0.001 and P = 0.012, respectively). Thigh temperature increased similarly among the three groups. The incidence of shivering was significantly less in Group I and Group D than Group V (20%, 13.3%, and 53.3%, respectively P = 0.035).

Conclusion: Preoperative use of air warmers and warm i.v fluids averts hypothermia and shivering and also reduces the rate of SSIs due to higher core and wound temperature.