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The Effect of Prewarming on Early Postoperative Thermal Comfort and Shivering in Adult Surgical Patients: A
1Faculty of Nursing, Akdeniz University, Antalya, Turkey.
Purpose:
This study investigated the effect of prewarming on early postoperative thermal comfort and shivering in adult surgical patients.
Design:
Systematic review and meta-analysis of randomized controlled trials.
Methods:
On March 5, 2025, a literature search was conducted across the PubMed, ScienceDirect, Scopus, Web of Science, Cochrane Central, SpringerLink, and EBSCOhost databases, covering all records up to that date, with no year restriction. Randomized controlled trials evaluating prewarming and reporting early postoperative thermal comfort and/or shivering were included. Methodological quality was assessed using the Cochrane Collaboration's risk-of-bias tool. Meta-analyses were performed in Comprehensive Meta-Analysis V2 using a random-effects model. Moderator analyses and publication bias assessments (funnel plot inspection, Orwin's fail-safe N, and trim-and-fill) were also conducted.
Findings:
A total of 369 articles were screened; 13 studies were included in the systematic review, and 11 studies were included in the meta-analysis. In the random-effects model, the meta-analysis showed that prewarming significantly improved early postoperative thermal comfort (Hedges' g = 0.396, 95% CI 0.232 to 0.559, P < .001; n = 1,166) and reduced early postoperative shivering (Hedges' g = 0.341, 95% CI 0.214 to 0.468, P < .001; n = 1,174). In the random-effects model, between-study heterogeneity was moderate for early postoperative thermal comfort (I² = 47.24%) and low for early postoperative shivering (I² = 15.86%). Potential moderators included anesthesia type, American Society of Anesthesiologists classification, anesthesia duration, surgery type, warming method, and prewarming duration.
Conclusions:
Prewarming is effective for improving early postoperative thermal comfort and reducing shivering in adult surgical patients.
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