- Actively prewarm patients in preoperative area for approximately 1 hour with forced-air heating or resistive-heating blanket.
- Keep the ambient temperature of the operating room at a minimum of 73°F.
- Monitor core temperature throughout administration of general and regional anesthesia.
- Cover as much body surface area as possible with blankets or drapes to reduce radiant and convective heat loss through the skin.
- Actively warm patients intraoperatively with forced-air heaters or resistive-heating blanket to prevent heat loss and add heat content. Rearrange covers every time patient is repositioned to warm as much surface area as possible.
- Minimize repositioning time as much as possible so that the active warming method can be quickly continued.
- Warm intravenous fluids and/or infiltration fluids if large volumes are used. Warm incision irrigation fluids.
- Aggressively treat postoperative shivering with forced-air heater or resistive-heating blanket and consider pharmacologic intervention.
REFERENCESThe minimum OR temperature recommended in the literature is 22°C (71.6°F), and most researchers agree that an ambient temperature of at least 23°C (73.4°F) is better. Sessler recommends an OR temperature of 25°C (77°F). One study by El-Gamal and colleagues determined that nearly all cases of perioperative hypothermia could be eliminated if OR temperatures were 26°C (79°F).