Temperature Control in Conventional Abdominal Surgery: Comparison between Conductive and the Association of Conductive and Convective Warming

Intraoperative hypothermia is a common complication, and its development is favored by abdominal surgeries. The efficacy of the association of conductive and convective warming methods in the prevention of hypothermia, and its effects during postoperative recovery were the objectives of this study. Forty-three patients of both genders, ages 18 to 88 years, undergoing xyphopubic laparotomy under general anesthesia and monitoring of the esophageal temperature were randomly divided in two groups, according to the warming method: COND (n=24), circulating-water mattress at 37° C on the back, and COND + CONV (n=19), circulating-water mattress associated with warm air blanket at 42° C over the thorax and upper limbs. Weight, gender, age, duration of surgery and anesthesia, temperature on anesthetic induction (Mi), consecutive hours (M1, M2), end of surgery (Mes) and anesthesia (Mea), and admission (Ma-REC) and discharge (Md-REC) from the post-anesthetic recovery room (PARR), besides the postoperative incidence of tremors and complaints of cold, were analyzed. Both groups were similar regarding all parameters analyzed, except temperatures on M2, M3, M4, Mes, and Mea. The temperature of patients in the COND group decreased from the second hour of anesthetic induction on, but in the COND + CONV group it only happened in the fourth hour. Patients in the COND group presented hypothermia upon admission and discharge from the PARR. The association of different warming methods delayed the beginning and reduced the severity of intraoperative hypothermia, but it did not reduce the complaints of feeling cold and tremors. Hipotermia intra-operatória é complicação frequente, favorecida por operação abdominal. A eficácia da associação dos métodos de aquecimento por condução e convecção na prevenção de hipotermia e seus efeitos no período de recuperação pós-operatória foram os objetivos deste estudo. Quarenta e três pacientes de ambos os sexos de 18 a 88 anos de idade, submetidos à laparotomia xifopúbica sob anestesia geral e monitorização da temperatura esofágica, foram distribuídos de modo aleatório em dois grupos de aquecimento: COND (n=24), com colchão de circulação de água a 37°C no dorso e COND + CONV (n=19), com a mesma condição associada à manta de ar aquecido a 42°C sobre o tórax e membros superiores. Analisados peso, sexo, idade, duração da operação e anestesia, temperaturas na indução anestésica (Mi), horas consecutiva (M1, M2), final da operação (Mfo) e anestesia (M