Background and Goal of Study: In the supine position, forced-air warming is more effective on the lower body than on the upper body to prevent intraoperative hypothermia. However, it is unknown in the lateral decubitus position. We thus compared forced-air warmings on the upper and lower bodies in the lateral position.
Materials and Methods: Patients were randomised to receive forced-air warming on the upper body or lower body during thoracoscopic surgery in the lateral position. We measured the nasopharyngeal temperature at 0, 30, 60, 90, and 120 min after lateral positioning during surgery and the infrared tympanic membrane temperature at 0, 30, 60, 90 and 120 min after surgery. Patients received both upper and lower
body warmings at a temperature of <35.5°C. The primary outcome was the incidence of intraoperative hypothermia with a temperature of <36.0°C.
Results and Discussion: Intraoperative hypothermia was less frequent with the upper-body warming than with the lower-body warming [21/62 vs 35/61, risk ratio (95% CI) 0.6 (0.4–0.9), P=0.011]. The intraoperative temperature was higher with the upper-body warming than with the lower-body warming at 30 (P=0.002), 60
(P<0.001), and 90 (P<0.001) min after lateral positioning, and the postoperative temperature was higher at 0 (P<0.001) and 30 (P=0.001) min after surgery. Fewer patients received both upper and lower body warmings in the upper-body warming group than in the lower-body warming group during surgery (1 vs 7,P=0.032).
Conclusion(s): Forced-air warming was more effective on the upper body than on the lower body to prevent hypothermia during thoracoscopic surgery in the lateral decubitus position.

12 / Upper versus lower body forced-air warming to prevent hypothermia during thoracoscopic surgery in the lateral decubitus position: a randomised controlled trial