The Impact of Intravenous Glucose Administration on Maintenance of Body Temperature during Total Knee Replacement under Spinal Anesthesia in Geriatric Patients: A Randomized Controlled Trial

Background: Total knee replacement (TKR), more common in the elderly, can cause inadvertent perioperative hypothermia, which can be prevented. Preoperative intravenous (IV) glucose may minimize heat loss by increasing metabolism and heat generation. Objective: This study examined how preoperative IV 10% glucose affected body temperature in elderly TKR patients under spinal anesthesia (SA). Methods: This randomized controlled trial involved 78 ASA I-II elderly patients scheduled for elective TKR under SA. Eligible patients were randomly allocated into two equal groups: group A received a 10% glucose infusion, while group B received 0.9% normal saline (NS), administered 6 hours before surgery. The occurrence of hypothermia was the primary outcome. Results: At the end of surgery, group B exhibited a notable significant lower value of core temperature (p<0.001) with a non-significant alteration in surface temperature (p=0.087) than group A. Group B experienced more adverse effects compared to group A with statistically significant differences, particularly hypothermia (p= 0.040) and shivering (p=0.007). Conclusions: Elderly individuals undergoing total knee replacement under spinal anesthesia may benefit from a preoperative intravenous infusion of 10% glucose to help control body temperature and avoiding shivering.