Effect of administration of pre-warmed intravenous fluids on the frequency of hypothermia following spinal anesthesia for Cesarean delivery

Kenji Yokoyama, Manzo Suzuki, Yoichi Shimada, Takashi Matsushima, Hiroyasu Bito, Atsuhiro Sakamoto
Journal of Clinical Anesthesia 2009, 21 (4): 242-8

STUDY OBJECTIVE: To determine whether administration of pre-warmed colloid followed by pre-warmed crystalloid solution prevents the development of hypothermia in patients undergoing Cesarean delivery.

DESIGN: Randomized, double-blind, placebo-controlled study.

PATIENTS: 30 parturients scheduled to undergo elective Cesarean delivery during spinal anesthesia.

INTERVENTIONS: Patients assigned to the warmed fluid group (n=15) received pre-warmed colloid with average molecular weight of 70,000 daltons and substitution ratio of 0.55, followed by pre-warmed crystalloid (kept in warmed storage maintained at 41 degrees C) during surgery. Patients assigned to the unwarmed fluid group (n=15) received non-warmed infusion. All patients received 400 mL before spinal anesthesia followed by another 300 mL before delivery of the newborn. After completion of a 1,000 mL infusion of colloid fluid, acetate Ringer's solution was infused.

MEASUREMENTS: Core temperature measured at the tympanic membrane, and forearm and fingertip skin temperatures were recorded just after arrival at the operating room (baseline), after administration of spinal anesthesia (spinal ), at incision (incision), at delivery of the newborn (delivery), and at 15, 30, and 45 minutes after delivery. Rectal temperature of the baby, Apgar scores at one and 5 minutes after delivery, and umbilical artery pH were evaluated.

MAIN RESULTS: Core temperature was significantly higher in the warmed fluid group from the time of delivery to 45 minutes after delivery. Apgar scores at one minute after delivery and umbilical arterial pH were significantly higher in the warmed fluid group.

CONCLUSION: Administration of pre-warmed intravenous colloid followed by crystalloids maintained core temperature during Cesarean delivery and induced higher Apgar scores and umbilical arterial pH.

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