Are active warming measures required during paediatric cleft surgeries?

Area of Science:

• Anesthesiology
• Pediatric Surgery

Background:

• Intraoperative heat loss in pediatric cleft surgery is minimal.
• Active warming measures to prevent hypothermia may paradoxically lead to hyperthermia.
• Understanding temperature regulation during these procedures is crucial.

Purpose of the Study:

• To determine the incidence of hyperthermia with active warming and hypothermia without active warming in pediatric cleft surgeries.
• To compare the rate of intraoperative temperature changes with and without active warming.

Main Methods:

• 120 pediatric patients undergoing cleft lip and palate repair were studied.
• Group A received forced air warming (38°C) post-induction; Group B received no active warming.
• Body temperature was recorded every 30 minutes from induction until 180 minutes or surgery end.

Main Results:

• Group A (active warming) showed significantly higher intraoperative temperatures than baseline.
• Group B (no warming) experienced significant temperature reduction in the first 60 minutes.
• Maximum temperature increase in Group A occurred between 120-150 minutes; maximum decrease in Group B was in the first 30 minutes.

Conclusions:

• Active warming is recommended for the initial 30 minutes of pediatric cleft surgery if the duration is less than 2 hours.
• For surgeries exceeding 2 hours, active warming measures may not be necessary.
• This suggests a duration-dependent approach to intraoperative warming in pediatric cleft repair.