A randomized trial of prewarming on patient satisfaction and thermal comfort in outpatient surgery

Abstract

Study objective: To test the primary hypothesis that forced-air prewarming improves patient satisfaction after outpatient surgery and to evaluate the effect on core temperature and thermal comfort.

Design: Prospective randomized controlled trial.

Setting: Preoperative area, operating room, and postanesthesia care unit.

Patients: A total of 115 patients aged 18 to 75 years with American Society of Anesthesiologists status <4 and body mass index of 15 to 36kg/m(2) who were undergoing outpatient surgery (duration <4 hours).

Interventions: Patients were randomized to active prewarming with a Mistral-Air warming system initially set to 43°C or no active prewarming. All patients were warmed intraoperatively.

Measurements: Demographic and morphometric characteristics, perioperative core temperature, ambient temperature, EVAN-G satisfaction score, thermal comfort via visual analog scales.

Main results: Data from 102 patients were included in the final analysis. Prewarming did not significantly reduce redistribution hypothermia, with prewarmed minus not prewarmed core temperature differing by only 0.18°C (95% confidence interval [CI], -0.001 to 0.37) during the initial hour of anesthesia (P=.052). Prewarming increased the mean EVAN-G satisfaction score, although not significantly, with an overall difference (prewarmed minus not prewarmed) of 5.6 (95% CI, -0.9 to 12.2; P=.09). Prewarming increased thermal comfort, with an overall difference of 6.6 mm (95% CI, 1.0-12.9; P=.02).

Conclusion: Active prewarming increased thermal comfort but did not significantly reduce redistribution hypothermia or improve postoperative patient satisfaction.

Keywords: Anesthesia; Normothermia; Outpatient surgery; Patient satisfaction; Prewarming; Thermoregulation.