Effect of Active and Passive Heating Methods Used in Different Areas of Perioperative Processes on Thermal Comfort and Anxiety: A Randomized Control Trial

Year 2022, Volume: 6 Issue: 1, 225 - 237, 27.01.2022

Pınar Tunç Tuna , Şerife Kurşun , İnci Kara

https://doi.org/10.30621/jbachs.950156

Cited By: 3

Abstract

Purpose: This study was conducted to determine the effects of active and passive heating methods applied in different parts of the perioperative process on thermal comfort, anxiety, and vital signs.
Design: This study was conducted with patients admitted for open abdominal surgery between October 1, 2018 and January 10, 2019. Patients were randomly allocated into three groups as follows: Group A (n = 33), Group B (n = 33), and Group C (control group; n = 33).
Methods: This study is a randomized, pretest–posttest controlled experimental design. Intervention Group A and B gowns blowing warm air were used as intervention tools. Procedural care (Group C) received routine hospital care. Vital signs, thermal comfort, and anxiety levels of the patients were evaluated.
Findings: Compared to those in Group B, for patients in Group A, the thermal comfort levels were higher and the anxiety levels were lower. The highest body temperature was seen in the patients in Group A. No difference was noted in blood pressure values between the groups. The pulse values of the patients in Groups A and B were significantly lower.
Conclusion: The use of gowns blowing warm air had a positive effect on the patients’ anxiety, thermal comfort, and vital signs.

Keywords

active heating, anxiety, blowing warm air, nursing, hypothermia, thermal comfort

Project Number

2018.1.11

References

• Kurz A. Physiology of thermoregulation. Best Practice & Research Clinical Anaesthesiology. 2008;22(4):627-44. https://doi.org/10.1016/j.bpa.2008.06.004
• Mason SE, Kinross JM, Hendricks J, Arulampalam TH. Postoperative hypothermia and surgical site infection following peritoneal insufflation with warm, humidified carbon dioxide during laparoscopic colorectal surgery: a cohort study with cost-effectiveness analysis. Surgical endoscopy. 2017;31(4):1923-9. DOI 10.1007/s00464-016-5195-0
• Turkish Society of Anaesthesiology and Reanimation. Turkish Society of Anaesthesiology and Reanimation Practice Guideline for Prevention of Unintentional Perioperative Hypothermia. Turk J Anaesth Reanim. 2013;41:188-90. DOI: 10.5152/TJAR.2013.64
• Reynolds L, Beckmann J, Kurz A. Perioperative complications of hypothermia. Best practice & research Clinical anaesthesiology. 2008;22(4):645-57. https://doi.org/10.1016/j.bpa.2008.07.005
• Rajagopalan S, Mascha E, Na J, Sessler DI. The effects of mild perioperative hypothermia on blood loss and transfusion requirement. Anesthesiology: The Journal of the American Society of Anesthesiologists. 2008;108(1):71-7. https://doi.org/10.1097/01.anes.0000296719.73450.52
• Good KK, Verble JA, Secrest J, Norwood BR. Postoperative hypothermia the chilling consequences. AORN journal. 2006;83(5):1054-66. https://doi.org/10.1016/S0001-2092(06)60116-6
• Kelly PA, Cooper SK, Krogh ML, Morse EC, Crandall CG, Winslow EH, et al. Thermal comfort and safety of cotton blankets warmed at 130° F and 200° F. Journal of PeriAnesthesia Nursing. 2013;28(6):337-46. https://doi.org/10.1016/j.jopan.2012.10.007
• Scott EM, Buckland R. A systematic review of intraoperative warming to prevent postoperative complications. AORN journal. 2006;83(5):1090-113. https://doi.org/10.1016/S0001-2092(06)60120-8
• Scott EM, Leaper DJ, Clark M, Kelly PJ. Effects of warming therapy on pressure ulcers—a randomized trial. AORN journal. 2001;73(5):921-38. https://doi.org/10.1016/S0001-2092(06)61744-4
• Walton-Geer PS. Prevention of pressure ulcers in the surgical patient. AORN journal. 2009;89(3):538-52. DOI: 10.1016/j.aorn.2008.12.022
• Tsuei BJ, Kearney PA. Hypothermia in the trauma patient. Injury. 2004;35(1):7-15. https://doi.org/10.1016/S0020-1383(03)00309-7
• O'Brien D, Greenfield MLV, Anderson JE, Smith BA, Morris M. Comfort, satisfaction, and anxiolysis in surgical patients using a patient-adjustable comfort warming system: a prospective randomized clinical trial. Journal of PeriAnesthesia Nursing. 2010;25(2):88-93. https://doi.org/10.1016/j.jopan.2010.01.008
• Macario A, Dexter F. What are the most important risk factors for a patient’s developing intraoperative hypothermia? Anesthesia & Analgesia. 2002;94(1):215-20. doi: 10.1213/00000539-200201000-00042
• Frank SM, Raja SN, Bulcao CF, Goldstein DS. Relative contribution of core and cutaneous temperatures to thermal comfort and autonomic responses in humans. Journal of Applied physiology. 1999;86(5):1588-93. https://doi.org/10.1152/jappl.1999.86.5.1588
• Kimberger O, Illievich U, Lenhardt R. The effect of skin surface warming on pre‐operative anxiety in neurosurgery patients. Anaesthesia. 2007;62(2):140-5. https://doi.org/10.1111/j.1365-2044.2007.04934.x
• Wagner D, Byrne M, Kolcaba K. Effects of comfort warming on preoperative patients. AORN journal. 2006;84(3):427-48. https://doi.org/10.1016/S0001-2092(06)63920-3
• Beyea SC. 2009 patient safety goals: a perioperative nursing priority. AORN journal. 2008;88(3):459-62. https://doi.org/10.1016/j.aorn.2008.08.008
• Galvão CM, Marck PB, Sawada NO, Clark AM. A systematic review of the effectiveness of cutaneous warming systems to prevent hypothermia. Journal of clinical nursing. 2009;18(5):627-36. https://doi.org/10.1111/j.1365-2702.2008.02668.x
• Schulz KF, Altman DG, Moher D, Group C. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. Trials. 2010;11(1):32.
• Akhtar Z, Hesler BD, Fiffick AN, Mascha EJ, Sessler DI, Kurz A, et al. A randomized trial of prewarming on patient satisfaction and thermal comfort in outpatient surgery. Journal of clinical anesthesia. 2016;33:376-85. https://doi.org/10.1016/j.jclinane.2016.04.041
• Kim EJ, Yoon H. Preoperative factors affecting the intraoperative core body temperature in abdominal surgery under general anesthesia: an observational cohort. Clinical nurse specialist. 2014;28(5):268-76. doi: 10.1097/NUR.0000000000000069
• Lee WP, Wu PY, Shih WM, Lee MY, Ho LH. The effectiveness of the newly designed thermal gown on hypothermic patients after spinal surgery. Journal of clinical nursing. 2015;24(19-20):2779-87. doi: 10.1111/jocn.12873
• Oner N, LeCompte WA. State-trait anxiety inventory handbook: Boğaziçi University Press; 1985.
• Park OB, Choi H. The effect of pre-warming for patients under abdominal surgery on body temperature, anxiety, pain, and thermal comfort. Journal of Korean Academy of Nursing. 2010;40(3):317-25. DOI: 10.4040/jkan.2010.40.3.317
• Conway A, Duff J, Sutherland J. Cost‐effectiveness of forced air warming during sedation in the cardiac catheterisation laboratory. Journal of advanced nursing. 2018;74(9):2075-81. https://doi.org/10.1111/jan.13707
• Kober A, Dobrovits M, Djavan B, Marberger M, Barker R, Bertalanffy P, et al. Local active warming: an effective treatment for pain, anxiety and nausea caused by renal colic. The Journal of urology. 2003;170(3):741-4. https://doi.org/10.1097/01.ju.0000080570.83834.ad
• Rymaszewska J, Kiejna A, Hadryś T. Depression and anxiety in coronary artery bypass grafting patients. European Psychiatry. 2003;18(4):155-60. DOI: https://doi.org/10.1016/S0924-9338(03)00052-X
• Wen R, Leslie K, Rajendra P. Pre‐operative forced‐air warming as a method of anxiolysis. Anaesthesia. 2009;64(10):1077-80. https://doi.org/10.1111/j.1365-2044.2009.06036.x
• Tanaka N, Ohno Y, Hori M, Utada M, Ito K, Suzuki T. High preoperative anxiety level and the risk of intraoperative hypothermia. International Journal of Clinical Medicine. 2012;3(06):461. DOI:10.4236/ijcm.2012.36085
• Taguchi A, Kurz A. Thermal management of the patient: where does the patient lose and/or gain temperature? Current Opinion in Anesthesiology. 2005;18(6):632-9. doi: 10.1097/01.aco.0000191890.36691.cc
• Broback BE, Skutle GØ, Dysvik E, Eskeland A. Preoperative warming with a forced-air warming blanket prevents hypothermia during surgery. Norwegian Journal of Clinical Nursing/Sykepleien Forskning. 2018. DOI: https://doi.org/10.4220/Sykepleienf.2018.65819
• Connelly L, Cramer E, DeMott Q, Piperno J, Coyne B, Winfield C, et al. The optimal time and method for surgical prewarming: a comprehensive review of the literature. Journal of PeriAnesthesia Nursing. 2017;32(3):199-209. https://doi.org/10.1016/j.jopan.2015.11.010
• Lau A, Lowlaavar N, Cooke EM, West N, German A, Morse DJ, et al. Effect of preoperative warming on intraoperative hypothermia: a randomized-controlled trial. Canadian Journal of Anesthesia/Journal canadien anesthesia. 2018;65(9):1029-40. https://doi.org/10.1007/s12630-018-1161-8
• Thomas L, Garcia R, Desilva R, Seabra T. Intraoperative Hypothermia: Effects of Pre-warming Using Forced-Air Warming in Colorectal Surgery. Journal of PeriAnesthesia Nursing. 2018;33(4).
• Kursun S, Dramali A. The effect of heating with an electric blanket on the rewarming time in the postoperative period in patients undergoing abdominal surgery. Journal of General Medicine. 2011;21(1).
• Benson EE, McMillan DE, Ong B. The effects of active warming on patient temperature and pain after total knee arthroplasty. AJN The American Journal of Nursing. 2012;112(5):26-33. DOI: 10.1097/01.NAJ.0000414315.41460.bf
• Grossman S, Bautista C, Sullivan L. Using evidence-based practice to develop a protocol for postoperative surgical intensive care unit patients. Dimensions of Critical Care Nursing. 2002;21(5):206-13.
• Torossian A, Van Gerven E, Geertsen K, Horn B, Van de Velde M, Raeder J. Active perioperative patient warming using a self-warming blanket (BARRIER EasyWarm) is superior to passive thermal insulation: a multinational, multicenter, randomized trial. Journal of clinical anesthesia. 2016;34:547-54. https://doi.org/10.1016/j.jclinane.2016.06.030
• Wagner VD. Misuse of forced‐air warming devices can be hazardous. Journal of Healthcare Risk Management. 2003;23(2):13-6. https://doi.org/10.1002/jhrm.5600230205
• Burns SM, Wojnakowski M, Piotrowski K, Caraffa G. Unintentional hypothermia: implications for perianesthesia nurses. Journal of PeriAnesthesia Nursing. 2009;24(3):167-76. https://doi.org/10.1016/j.jopan.2009.03.003
• Yang HL, Lee HF, Chu TL, Su YY, Ho LH, Fan JY. The comparison of two recovery room warming methods for hypothermia patients who had undergone spinal surgery. Journal of Nursing Scholarship. 2012;44(1):2-10. https://doi.org/10.1111/j.1547-5069.2011.01426.x
• Balaji S, Sullivan I, Deanfield J, James I. Moderate hypothermia in the management of resistant automatic tachycardias in children. Heart. 1991;66(3):221-4. http://dx.doi.org/10.1136/hrt.66.3.221
• Van Beek SDJ. The effect of hypothermia on physiological functions. 2013. In: Successful temperature management: A practical guide on how to prevent and treat hypothermia [Internet]. The Netherlands. 2. [21].
• Cam R, Yonem H, Ozsoy H. Core body temperature changes during surgery and nursing management. interventions. 2016;5:14.