Learning Track:	14. Perioperative Medicine
Title:	The impact of prewarming on core temperature and cases of inadvertant perioperative hypothermia in oncogynecologal surgery
Author(s):	Pasheev A.1, 2 Sayetgaraev A.1,2  Muftahutdinova G.2
Institute(s):	1Kazan State Medical Academy, Dept of Anaesthesiology & Intensive Care, Kazan, Russian Federation, 2Tatarstan Regional Clinical Cancer Center, Dept of Anaesthesiology & Intensive Care, Kazan, Russian Federation
Text:	Background: Inadvertent perioperative hypothermia (IPH) occurs in many patients , undergoing oncogynecological operations, due to the influence of the spinal anesthesia and sedation. The effect of warming techniques are insufficient to counteract thermal redistribution resulting from the peripheral vasodilatation, associated with spinal anesthesia. We tested the efficiency of the preoperative forced-air warming (FAW) device (Bair Paws) in combination with intravenous injection of tramadol in preventing IPH.
Methods: Eighty adult patients undergoing oncogynecological surgery under spinal anesthesia were randomized to receive either normal care or prewarming for 30 min, at 43C, using the Bair Paws, in combination with the injection of (0,5 mg/kg) tramadol preoperatively. 
Results: There was smaller decrease in mean core temperature in the prewarmed group at 15, 30, 75, 90 min post-induction (P < 0.05). 
By the end of the operation all patients from the control group remained hypothermic, whereas only 28 patients (70%) remained hypothermic in prewarmed group (P < 0.05).
26 (65%) patients from the control group and 10(25%) patients in prewarmed group suffered from muscle shivering (P < 0.05). There were no significant differences in vomiting and nausea between the groups. 
Conclusions: Preoperative warming using the Bair Paws, combined with preoperative injection of tramadol results in smaller decreases in core temperature intraoperatively and less IPH in patients undergoing oncogynecological surgery under spinal anaesthesia.
References: 
1. Sessler DI. Review: perioperative heat balance. Anesthesiology 2000; 92: 578-96
2.Camus Y, Delva E, Sessler DI, Lienhart A. Pre-induction skinsurface warming minimizes intraoperative core hypothermia. J Clin Anesth 1995; 7: 384-8.
3.Gamal T. Yousef, Khalid M. Elsayed Effect of forced air prewarming, tramadol or their combination on prevention of hypothermia and shivering during cesarean section under spinal anesthesia. Z.U.M.J.Vol.19; N.2; March; 2013 304-11.