Comparison of the Effect of Forced-air Warming and Warmed Intravenous Fluid on the Comfort and Prevention of Shivering After Spinal Anesthesia in Patients Undergoing Orthopedic Surgery

Mahdi Moheb; Mahboubeh Rezaei; Ismail Azizi-Fini; Fatemeh Atoof; Mohammad Ali Saadati

doi:10.1016/j.jopan.2022.01.010

Comparison of the Effect of Forced-air Warming and Warmed Intravenous Fluid on the Comfort and Prevention of Shivering After Spinal Anesthesia in Patients Undergoing Orthopedic Surgery

J Perianesth Nurs. 2022 Dec;37(6):865-871. doi: 10.1016/j.jopan.2022.01.010. Epub 2022 Sep 1.

Authors

Mahdi Moheb¹, Mahboubeh Rezaei², Ismail Azizi-Fini³, Fatemeh Atoof⁴, Mohammad Ali Saadati⁵

Affiliations

¹ Naghavi Hospital, Kashan University of Medical Sciences, Kashan, Iran.
² Surgical Technology Department, School of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran. Electronic address: m4.rezaei@gmail.com.
³ Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran.
⁴ Autoimmune Disease Research Center, Kashan University of Medical Sciences, Kashan, Iran.
⁵ School of Medicine, Kashan University of Medical Sciences, Kashan, Iran.

PMID: 36057498
DOI: 10.1016/j.jopan.2022.01.010

Abstract

Purpose: This study aimed to compare the effect of forced-air warming and warmed intravenous fluid on the comfort and prevention of shivering after spinal anesthesia in patients undergoing orthopaedic surgery.

Design: Randomized controlled clinical trial.

Methods: A total of 120 patients were randomly divided into three groups: forced-air warming (38°C), warmed intravenous fluid (37°C), and the control group. Patients' comfort and severity of shivering were measured and recorded five times (immediately and 15 minutes after spinal anesthesia, end of the surgery, time of entrance to the recovery room, and 15 minutes after entering the recovery room), and compared with each other.

Findings: There was a significant difference between the three groups in terms of comfort at all points of evaluation times (P < .001). The comfort score in the control group was significantly higher than the two intervention groups (P < .001). Moreover, the comfort score in the warmed intravenous fluid group was significantly higher than the forced-air warming group (P < .001). In addition, there was a significant difference in shivering severity between the three groups at the end of the surgery, entrance to the recovery room, and 15 minutes after surgery (P < .001). The majority of patients in the forced-air warming group (90%) had no shivering at all three times, while the warmed IV fluid and control groups was 65% and 30% respectively.

Conclusions: Non-pharmacological methods such as forced-air warming and warmed intravenous fluid can provide comfort and prevent shivering in orthopaedic patients undergoing spinal anesthesia. However, the use of forced-air warming is more effective than warmed intravenous fluid in providing comfort and preventing shivering in these patients. It is recommended that these methods be used in the operating room to provide comfort and prevent shivering in these patients.

Keywords: comfort; forced-air warming; orthopaedic surgery; shivering; spinal anesthesia.

Publication types

Randomized Controlled Trial

MeSH terms

Anesthesia, Spinal* / adverse effects
Anesthesia, Spinal* / methods
Humans
Hypothermia* / prevention & control
Orthopedic Procedures*
Orthopedics*
Shivering