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Updated: Sep 16, 2025

Esophageal Heat Transfer for Patient Temperature Control and Targeted Temperature Management
Published on: November 21, 2017
Effectiveness of active warming to prevent shivering during elective cesarean delivery under spinal anesthesia:
Li Wan1, Dong-Mei Li2, Chen-Chen Shen3
1Anesthesiology and Perioperative Medicine, Jiaxing Maternity and Children Health Care Hospital, Affiliated Women and Children Hospital of Jiaxing University, Jiaxing, China.
Background:
Active warming (AW) is commonly used to prevent hypothermia during cesarean delivery (CD).
Objective:
To evaluate the effects of AW on shivering during CD under spinal anesthesia (SA).
Search Strategy:
PubMed, Embase, CENTRAL, Web of Science, and Wanfang were searched without language or date restrictions.
Selection Criteria:
Randomized controlled trials (RCTs) evaluating forced-air warming (FAW), intravenous fluid (IVF) warming, and warmed mattresses alone or in combination for shivering during CD under SA.
Data Collection And Analysis:
A random effects model was used to compare AW with no AW and combined AW with single AW on shivering and hypothermia.
Main Results:
Twenty-four RCTs were included. AW reduced the incidence of shivering (risk ratio [RR] 0.38, 95% confidence interval [CI] 0.28-0.50) and hypothermia (RR 0.50, 95% CI 0.37-0.68) compared with no AW, but combined AW provided no additional benefit over single AW for shivering (RR 0.72, 95% CI 0.50-1.05) or hypothermia (RR 0.59, 95% CI 0.27-1.29). Different AW methods, different durations of FAW, and the use of intrathecal opioids did not affect the effects of AW on shivering.
Conclusions:
AW techniques, either alone or in combination, are equivalent in preventing shivering during elective CD under SA.
Prospero Registration:
No. CRD42024555800.
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