Evaluating Shivering and Hypothermia After Removing Forced-Air Heating From Short-Duration Surgery

Area of Science:

• Anesthesiology
• Patient Safety
• Health Economics

Background:

• Single-use forced-air heating blankets prevent intraoperative hypothermia but incur environmental and economic costs.
• The impact of omitting these blankets for short-duration surgeries on patient outcomes is not well understood.

Purpose of the Study:

• To evaluate the effects of removing forced-air heating on shivering and hypothermia during short-duration surgical procedures.

Main Methods:

• A pragmatic, prospective before-and-after cohort study was conducted in a secondary university hospital in 2023.
• Adult patients undergoing orthopaedic or abdominal procedures lasting less than 90 minutes were included.
• Co-primary outcomes were intraoperative hypothermia (<35.5°C) and post-anaesthetic care unit (PACU) shivering, comparing active forced-air heating to no heating.

Main Results:

• Omitting forced-air heating led to a significant increase in intraoperative hypothermia (5.58% vs 2.73%) and shivering (6.1% vs 4.0%).
• The estimated cost to prevent one shivering event was $235 and 62.9 kg CO2 equivalents.
• No significant differences were observed in anesthesia emergence time or PACU stay duration.

Conclusions:

• Removing forced-air heating for short surgeries significantly increased hypothermia and shivering incidence.
• This practice reduces costs and carbon emissions, presenting a controversial balance between patient well-being and environmental/economic benefits.
• Further research is needed to explore patient perspectives on thermal comfort outcomes.