Operating room temperature prior to surgical draping: effect on patient temperature in recovery room

Assessment was made of whether a cold-room environment prior to surgical draping affected patient temperature or the incidence of shivering in the recovery room in patients undergoing major vascular surgery when warming blankets and warmed fluids were used to maintain intraoperative temperature. Forty-two patients scheduled to undergo major vascular surgery were randomly assigned in equal numbers to a "cold or "warm" room. Temperatures in the "warm" rooms were 22.2 C or above (range 22.8-25.6 C) until draping, and in "cold" rooms, 18.9 C or below (ranged 13.9-17.8 C). Once surgical drapes were placed, the room temperature control was set at its minimum, 17 C. All intravenous fluids and blood were warmed to 37.5 C, and a heating blanket was maintained at 37.8 C before and during the operative procedure. Patient temperatures initially did not differ between groups. Despite significantly greater heat loss prior to draping in the cold-room group (0.63 +/- 0.14 C) than in the warm-room group (0.32 +/- 0.10 C) (p < 0.01), there were no differences in temperature in the recovery room, shivering, myocardial, renal CNS, pulmonary, or graft morbidity in the two groups. In major intra-abdominal vascular operations the use of warming blankets and the practice of warming all fluids for infusion allow a comfortable room temperature without detriment to patient care.