Is there thermal benefit from preoperative warming in children?

Area of Science:

• Anesthesiology
• Pediatric Care
• Thermoregulation

Background:

• Prewarming patients before anesthesia may reduce postinduction core temperature drop.
• Optimal prewarming temperature and duration are not established for pediatric patients.
• Warming the operating environment is common practice for infants and neonates.

Purpose of the Study:

• To quantify the impact of raised preoperative ambient temperature (T(ambient)) on core temperature (T(core)) in children post-anesthesia induction.
• To assess the benefit of preoperative warming as a technique to maintain T(core).

Main Methods:

• Prospective clinical study involving children undergoing elective surgery with >20 min anesthetic duration.
• Children randomized to either 26°C (raised) or 21°C (standard) T(ambient) for preoperative warming.
• Continuous esophageal temperature monitoring (T(core)) from induction until the start of surgery.

Main Results:

• The 26°C T(ambient) group had a significantly higher initial T(core) (0.4°C warmer).
• The warmed group experienced less T(core) drop (0.18°C benefit at 20 min).
• Warmer T(ambient) provided a consistent thermal benefit regardless of patient age or size.

Conclusions:

• Statistically significant thermal advantages exist with preoperative environmental warming.
• Data supports anesthetists in determining the clinical relevance of preoperative warming.
• Raised T(ambient) is an effective method to improve perioperative T(core) management in children.