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Abstract
Background and Aims: Unintended hypothermia (UIH) during surgery under general anaesthesia has adverse implications. A retrospective analysis of the perioperative temperature records of healthy voluntary liver donors was done to evaluate the efficacy of a multimodal protocol for temperature management. Methods: Records of 50 American Society of Anesthesiologists physical status Class 1 patients operated for Donor Hepatectomy lasting >2 h under combined general and epidural anaesthesia were analysed. Ambient temperature was maintained 24C-27C before induction of GA and during insertion of epidural catheter. Active warming was done using warming mattress set to temperature 38C, hot air blanket with temperature set to 38C and fluid warming device (Hotline(TM)) with preset temperature of 41C. Nasopharyngeal temperature was continuously monitored. After induction of GA and draping of the patient, ambient temperature was decreased and maintained at 21C-24C and was again increased to 24C-27C at the conclusion of surgery. During surgery, for every 0.1C above 37C, one heating device was switched off such that at 37.3C all the 3 devices were switched off. Irrigation fluid was pre-warmed to 39C. Results: Baseline temperature was 35.9C +- 0.4C. Minimum temperature recorded was 35.7C +- 0.4C. Mean decrease in temperature below the baseline temperature was 0.2C +- 0.2C. Temperature at the end of surgery was 37.4C +- 0.5C. Conclusion: Protocol-based temperature management with simultaneous use of resistive heating mattress, forced-air warming blanket, and fluid warmer along with ambient temperature management is an effective method to prevent unintended perioperative variation in body temperature.