Dario Galante, Giuseppe Pellico
University Department of Anesthesia and Intensive Care and University Hospital -Ospedali Riuniti of Foggia , Italy

Address for Correspondence: Dario Galante, Viale Ofanto 221, 71100 Foggia, Italy . Email: dario.galante@tin.it

This study assessed the relative efficiency of a forced-air warmer (Bair Hugger) (1) commonly used in our experience to prevent body hypothermia during neonatal surgery.

A retrospective study was performed in 80 neonates aged 0 - 30 days, ASA I-II, undergoing general balanced anesthesia for genitourinary, abdominal and thoracic surgery. ECG, SpO2, ETCO2, NIBP were monitored. Anesthesia was performed with thiopental, cisatracurium, Air/O2/Sevoflurane, fentanyl or remifentanil. All patients were warmed by a Bair Hugger (Augustine Medical Inc.) forced-air heater with blankets 555 pediatric full access model. Distal esophageal temperatures were continuously monitored during all the time of operation. Time zero (T0) was referred to induction of anesthesia. At T0 the forced air-warmer was regulated to high setting and then decreased to medium setting when core temperature reached 37°C or more.

At T0 temperatures recorded were 36.5 0.3°C. During surgical procedures, esophageal temperatures decreased 0.5 1.2 °C in the first 45 minutes. After 120 and 180 minutes core temperatures were respectively 1⁰C and 1.3⁰C higher. As described in literature these increases of temperatures are not observed using circulating-water warming systems with real risk of hypothermia for long duration anesthesia. No complications were observed and hemodynamic and respiratory parameters maintained within the normal ranges.

Up to 90% of patients experience hypothermia perioperatively (2,3). Inadvertent hypothermia can have a profound physiological effect on neonates and infants body, varying from mild vasoconstriction and feeling cold to cardiac arrest and death. The Bair Hugger heater is effective during abdominal, genitourinary and thoracic surgery for anesthesia lasting two or more hours. The Bair Hugger warmed faster than other devices described in literature. It significantly contributes to successful management of outpatient anesthesia.