Efficacy of intravenous fluid warming for maintenance of core temperature during lower segment cesarean section under spinal anesthesia

Abstract

Introduction: Maintenance of body temperature of obstetrical patients undergoing cesarean section is complicated by a variety of factors including heat loss to atmosphere, infusion of fluids at room temperature, disruption of thermoregulatory mechanisms by epidural or spinal anesthesia and redistribution hypothermia. Infusion of warm fluids is an important method of heat conservation. Hence, we evaluated the efficacy of intravenous fluid warming in preventing hypothermia by observing the change in core temperature with intravenous fluids at room temperature (22°C and 39°C) in patients undergoing lower segment cesarean section under spinal anesthesia. Materials and Methods: Sixty-four patients belonging to ASA grade I and II were randomly allocated to either of the two groups. Group I received intravenous fluids at room temperature (22°C) and group II received intravenous fluids via fluid warmer (39°C). Core temperature was recorded at every 1 min for the first 5 min, followed by 10 min till the end of surgery using a tympanic thermometer. Results: The mean decrease in core temperature in group I was -2.184 ± 0.413 and -1.934 ± 0.439 in group II. The comparison of group I and II showed a statistically significant difference in mean core temperatures at times 5, 50, 60, 70, 80 and 90 min and immediately on arrival in the recovery room. A lower incidence of shivering was seen in group II patients, but the difference in the two groups was not statistically significant. Conclusion: Infusion of warm intravenous fluids resulted in a lesser degree of fall in core temperature, thereby providing a significant temperature advantage; however, this did not translate to prevention of postoperative shivering.

Keywords

• Hypothermia
• intravenous fluid warming
• shivering
• spinal anesthesia