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Open Access Highly Accessed Study protocol

Preventing hypothermia in elective arthroscopic shoulder surgery patients: a protocol for a randomised controlled trial

Jed Duff123*, Renatta Di Staso1, Kerry-Anne Cobbe1, Nicole Draper1, Simon Tan1, Emma Halliday1, Sandy Middleton23, Lawrence Lam4 and Kim Walker123

Author Affiliations

1 St Vincent’s Private Hospital, Victoria Street, Darlinghurst, NSW, 2010, Australia

2 Nursing Research Institute, St Vincent’s & Mater Health Sydney-Australian Catholic University, Victoria Street, Darlinghurst, NSW, 2010, Australia

3 National Centre for Clinical Outcomes Research (NaCCOR), Nursing and Midwifery, ACU, Australia

4 The University of Notre Dame Australia, 60 Oxford Street, Darlinghurst, NSW, 2010, Australia

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BMC Surgery 2012, 12:14  doi:10.1186/1471-2482-12-14

Published: 20 July 2012

Abstract

Background

Patients having arthroscopic shoulder surgery frequently experience periods of inadvertent hypothermia. This common perioperative problem has been linked to adverse patient outcomes such as myocardial ischaemia, surgical site infection and coagulopathy. International perioperative guidelines recommend patient warming, using a forced air warming device, and the use of warmed intraoperative irrigation solutions for the prevention of hypothermia in at-risk patient groups. This trial will investigate the effect of these interventions on patients’ temperature, thermal comfort, and total recovery time.

Method/Design

The trial will employ a randomised 2 x 2 factorial design. Eligible patients will be stratified by anaesthetist and block randomised into one of four groups: Group one will receive preoperative warming with a forced air warming device; group two will receive warmed intraoperative irrigation solutions; group three will receive both preoperative warming and warmed intraoperative irrigation solutions; and group four will receive neither intervention. Participants in all four groups will receive active intraoperative warming with a forced air warming device. The primary outcome measures are postoperative temperature, thermal comfort, and total recovery time. Primary outcomes will undergo a two-way analysis of variance controlling for covariants such as operating room ambient temperature and volume of intraoperative irrigation solution.

Discussion

This trial is designed to confirm the effectiveness of these interventions at maintaining perioperative normothermia and to evaluate if this translates into improved patient outcomes.

Australian New Zealand Clinical Trials Registry number

ACTRN12610000591055