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Are active warming measures required during paediatric cleft surgeries?

Sunil Rajan1, Kusuma Ramachandra Halemani, Nitu Puthenveettil

  • 1Department of Anaesthesiology, Amrita Institute of Medical Sciences and Research Center, Kochi, Kerala, India.

Indian Journal of Anaesthesia
|October 29, 2013
PubMed

Insights

Active warming in pediatric cleft surgery may cause hyperthermia. For surgeries under 2 hours, use active warming for the first 30 minutes; otherwise, no warming is needed.

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.
Abstract

Keywords:
Active warminghyperthermiahypothermiapaediatric cleft surgeries

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