A prospective randomized study of the efficacy of continuous active warming in patients undergoing laparoscopic gastrectomy

Abstract Despite evidence has shown that the core temperature below 36℃ under surgery would lead to a sequence of adverse complications, and active warming measures are taken in order to reduce the incidence of the intraoperative hypothermia, core temperature disturbance during laparoscopic gastrectomy is common. The purpose of this research was to determine if a significant difference between continuous active warming (CAW) and active warming when body temperature is below 36℃ (BAW) in terms of incidence of intraoperative hypothermia and clinical rehabilitation in patients undergoing laparoscopic gastrectomy surgery. Patients assigned to CAW group were warmed immediately since the surgical incision procedure, the others were warmed while the body bladder temperature dropped to 36℃. The bladder temperature of the patient was recorded every 30 minutes during the operation. The primary outcome was the incidence of intraoperative hypothermia. Secondary outcomes included presence of shivering and agitation after operation, the time from end of surgery to tracheal extubation, postoperative pain score, the time to first postoperative flatus, postoperative complications, and the inflammatory markers. The overall incidence of hypothermia was 16.13% in 62 patients who underwent elective total laparoscopic radical gastrectomy. The incidence of shivering and agitation after operation was both 3.23% in CAW group, and it was 32.26% and 29.03% in BAW group. Time from end of surgery to tracheal extubation in CAW group was significantly lower than BAW group. In addition, continuous active warming could shorten time to first postoperative flatus of patients and relieve postoperative pain. In general, continuous active warming in patients undergoing laparoscopic gastrectomy decreased the incidence of intraoperative hypothermia and contributed to postoperative rehabilitation. Clinical trial registration: Registered at Chinese Clinical Trial Registry (ChiCTR) on 20/07/2024.