{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T20:58:16Z","timestamp":1791493096723,"version":"4.3.4"},"reference-count":38,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2019,11,11]],"date-time":"2019-11-11T00:00:00Z","timestamp":1573430400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2019,11,11]],"date-time":"2019-11-11T00:00:00Z","timestamp":1573430400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Prewarming has been shown to prevent intraoperative inadvertent hypothermia. Nevertheless, data about optimal prewarming-time from published clinical trials report contradictory results. We conducted this pilot study to evaluate routine clinical practice regarding prewarming and its effect on the prevalence of perioperative hypothermia in patients undergoing transurethral resection (TUR) under spinal anesthesia. This was a prospective, observational, pilot study to examine clinical practice in a tertiary hospital regarding prewarming in 140 consecutive patients. When prewarming (pw) was performed, forced-air warming was provided in the pre-anesthesia room for 15 (pw15), 30 (pw30), or 45 (pw45) min. Tympanic temperature was recorded upon entering the pre-anesthesia room, at the time of initiating surgery, and every 15\u2009min intra-operatively. We also recorded duration of the surgical procedure and length of stay in the Post-Anesthesia Care Unit (PACU). Pw15 was performed in 34 patients, pw30 in 29 patients, and pw45 in 21 patients. Fifty-six patients did not receive pw and 96% of them developed hypothermia at the end of the surgical procedure, compared to 73% of patients in pw15 (p\u2009=\u20090.002), 75% in pw30 (p\u2009=\u20090.006) and 90% in pw45 (p\u2009=\u20090.3). Length of stay in the PACU was markedly shorter in pw15 (131\u2009\u00b1\u200969\u2009min) and pw30 (123\u2009\u00b1\u200960 min) than in the non-pw group (197\u2009\u00b1\u2009105\u2009min) (p\u2009=\u20090.015 and p\u2009=\u20090.011, respectively). This difference was not significant in pw45 (129\u2009\u00b1\u200956\u2009min) compared to non-pw patients. In conclusion, prewarming for 15 or 30\u2009min before TUR under spinal anesthesia prevents development of hypothermia at the end of the surgical procedure.<\/jats:p>","DOI":"10.1038\/s41598-019-52960-6","type":"journal-article","created":{"date-parts":[[2019,11,11]],"date-time":"2019-11-11T11:03:16Z","timestamp":1573470196000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Prospective observational study of the effectiveness of prewarming on perioperative hypothermia in surgical patients submitted to spinal anesthesia"],"prefix":"10.1038","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2817-3144","authenticated-orcid":false,"given":"\u00c1ngel","family":"Becerra","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luc\u00eda","family":"Valencia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Ferrando","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jes\u00fas","family":"Villar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aurelio","family":"Rodr\u00edguez-P\u00e9rez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,11,11]]},"reference":[{"key":"52960_CR1","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1111\/j.1744-1609.2011.00227.x","volume":"9","author":"S Moola","year":"2011","unstructured":"Moola, S. & Lockwood, C. Effectiveness of strategies for the management and\/or prevention of hypothermia within the adult perioperative environment. Int J Evid Based Healthc. 9, 337\u201345 (2011).","journal-title":"Int J Evid Based Healthc."},{"key":"52960_CR2","first-page":"163","volume":"78","author":"M Putzu","year":"2007","unstructured":"Putzu, M., Casati, A., Berti, M., Pagliarini, G. & Fanelli, G. Clinical complications, monitoring and management of perioperative mild hypothermia: anesthesiological features. Acta Biomed. 78, 163\u20139 (2007).","journal-title":"Acta Biomed."},{"key":"52960_CR3","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1186\/s12871-018-0582-9","volume":"18","author":"J Yi","year":"2018","unstructured":"Yi, J., Liang, H., Song, R., Xia, H. & Huang, Y. Maintaining intraoperative normothermia reduces blood loss in patients undergoing mayor operations: a pilot randomized controlled clinical trial. BMC Anesthesiol. 18, 126 (2018).","journal-title":"BMC Anesthesiol."},{"key":"52960_CR4","doi-asserted-by":"publisher","first-page":"2655","DOI":"10.1016\/S0140-6736(15)00981-2","volume":"387","author":"DI Sessler","year":"2016","unstructured":"Sessler, D. I. Perioperative thermoregulation and heat balance. Lancet. 387, 2655\u201364 (2016).","journal-title":"Lancet."},{"key":"52960_CR5","doi-asserted-by":"publisher","first-page":"1330","DOI":"10.1097\/00000542-200005000-00022","volume":"92","author":"SM Frank","year":"2000","unstructured":"Frank, S. M., El-Rahmani, H. K., Cattaneo, C. G. & Barnes, R. A. Predictors of hypothermia during spinal anesthesia. Anesthesiology. 92, 1330\u20134 (2000).","journal-title":"Anesthesiology."},{"key":"52960_CR6","doi-asserted-by":"publisher","first-page":"578","DOI":"10.1097\/00000542-200002000-00042","volume":"92","author":"DI Sessler","year":"2000","unstructured":"Sessler, D. I. Perioperative heat balance. Anesthesiology. 92, 578\u201396 (2000).","journal-title":"Anesthesiology."},{"key":"52960_CR7","first-page":"1445","volume":"20","author":"H Bayir","year":"2016","unstructured":"Bayir, H. et al. Effect of perioperative inadvertent hypothermia on the ECG parameters in patients undergoing transurethral resection. Eur Rev Med Pharmacol Sci. 20, 1445\u20139 (2016).","journal-title":"Eur Rev Med Pharmacol Sci."},{"key":"52960_CR8","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1097\/EJA.0000000000000369","volume":"33","author":"EP Horn","year":"2016","unstructured":"Horn, E. P. et al. Warming before and after epidural block before general anaesthesia for major abdominal surgery prevents perioperative hypothermia: A randomised controlled trial. Eur J Anaesthesiol. 33, 334\u201340 (2016).","journal-title":"Eur J Anaesthesiol."},{"key":"52960_CR9","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1111\/j.1399-6576.1985.tb02293.x","volume":"29","author":"H Stjernstr\u00f6m","year":"1985","unstructured":"Stjernstr\u00f6m, H. et al. Thermal balance during transurethral resection of the prostate. A comparison of general anaesthesia and epidural analgesia. Acta Anaesthesiol Scand. 29, 743\u20139 (1985).","journal-title":"Acta Anaesthesiol Scand."},{"key":"52960_CR10","unstructured":"NICE. Inadvertent Perioperative Hypothermia: The Management of Inadvertent Perioperative Hypothermia in Adults. NICE Clinical Guideline No. 65 (2008)."},{"key":"52960_CR11","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1016\/j.jopan.2009.09.001","volume":"24","author":"VD Hooper","year":"2009","unstructured":"Hooper, V. D. et al. ASPAN\u2019s evidence-based clinical practice guideline for the promotion of perioperative normothermia; 2009. J Perianesth Nurs. 24, 271\u201387 (2009).","journal-title":"J Perianesth Nurs."},{"key":"52960_CR12","first-page":"166","volume":"112","author":"A Torossian","year":"2015","unstructured":"Torossian, A. et al. Preventing inadvertent perioperative hypothermia. Dtsch Arztebl Int. 112, 166\u201372 (2015).","journal-title":"Dtsch Arztebl Int."},{"key":"52960_CR13","doi-asserted-by":"publisher","first-page":"492","DOI":"10.1016\/j.jamcollsurg.2009.07.002","volume":"209","author":"SS Forbes","year":"2009","unstructured":"Forbes, S. S. et al. Evidence-based guidelines for prevention of perioperative hypothermia. J Am Coll Surg. 209, 492\u2013503 (2009).","journal-title":"J Am Coll Surg."},{"key":"52960_CR14","doi-asserted-by":"publisher","first-page":"564","DOI":"10.1016\/j.redar.2018.07.006","volume":"65","author":"JM Calvo Vecino","year":"2018","unstructured":"Calvo Vecino, J. M. et al. Clinical practice guideline. Unintentional perioperative hypothermia. Rev Esp Anestesiol Reanim 65, 564\u201388 (2018).","journal-title":"Rev Esp Anestesiol Reanim"},{"key":"52960_CR15","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1016\/j.jclinane.2017.01.005","volume":"38","author":"CA Shaw","year":"2017","unstructured":"Shaw, C. A., Steelman, V. M., DeBerg, J. & Schweizer, M. L. Effectiveness of active and passive warming for the prevention of inadvertent hypothermia in patients receiving neuraxial anesthesia: A systematic review and meta-analysis of randomized controlled trials. J Clin Anesth. 38, 93\u2013104 (2017).","journal-title":"J Clin Anesth."},{"key":"52960_CR16","doi-asserted-by":"crossref","first-page":"485","DOI":"10.4037\/ajcc2007.16.5.485","volume":"16","author":"L Lawson","year":"2007","unstructured":"Lawson, L. et al. Accuracy and precision of noninvasive temperature measurement in adult intensive care patients. Am J Crit Care 16, 485\u201396 (2007).","journal-title":"Am J Crit Care"},{"key":"52960_CR17","doi-asserted-by":"publisher","first-page":"282","DOI":"10.1016\/j.jclinane.2016.03.065","volume":"34","author":"AJ Wetz","year":"2016","unstructured":"Wetz, A. J. et al. Unexpectedly high incidence of hypothermia before induction of anesthesia in elective surgical patients. J Clin Anesth. 34, 282\u20139 (2016).","journal-title":"J Clin Anesth."},{"key":"52960_CR18","doi-asserted-by":"publisher","first-page":"5963","DOI":"10.1113\/jphysiol.2012.240739","volume":"590","author":"D Gagnon","year":"2012","unstructured":"Gagnon, D. & Kenny, G. P. Does sex have an independent effect on thermoeffector responses during exercise in the heat? J Physiol. 590, 5963\u201373 (2012).","journal-title":"J Physiol."},{"key":"52960_CR19","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1016\/S0034-9356(08)70610-8","volume":"55","author":"DA Rinc\u00f3n","year":"2008","unstructured":"Rinc\u00f3n, D. A., Valero, J. F. & Eslava-Schmalbach, J. Construction and validation of a model to predict intraoperative hypothermia. Rev Esp Anestesiol Reanim. 55, 401\u20136 (2008).","journal-title":"Rev Esp Anestesiol Reanim."},{"key":"52960_CR20","doi-asserted-by":"publisher","first-page":"674","DOI":"10.1097\/00000542-199503000-00009","volume":"82","author":"DI Sessler","year":"1995","unstructured":"Sessler, D. I., Schroeder, M., Merrifield, B., Matsukawa, T. & Cheng, C. Optimal duration and temperature of prewarming. Anesthesiology. 82, 674\u201381 (1995).","journal-title":"Anesthesiology."},{"key":"52960_CR21","doi-asserted-by":"publisher","first-page":"e0178600","DOI":"10.1371\/journal.pone.0178600","volume":"12","author":"B Rohrer","year":"2017","unstructured":"Rohrer, B. et al. Comparison of forced-air and water-circulating warming for prevention of hypothermia during transcatheter aortic valve replacement. PLoS ONE 12, e0178600 (2017).","journal-title":"PLoS ONE"},{"key":"52960_CR22","doi-asserted-by":"publisher","first-page":"376","DOI":"10.1016\/j.jclinane.2016.04.041","volume":"33","author":"Z Akhtar","year":"2016","unstructured":"Akhtar, Z. et al. A randomized trial of prewarming on patient satisfaction and thermal comfort in outpatient surgery. J Clin Anesth 33, 376\u201385 (2016).","journal-title":"J Clin Anesth"},{"key":"52960_CR23","doi-asserted-by":"publisher","first-page":"e0159772","DOI":"10.1371\/journal.pone.0159772","volume":"11","author":"YJ Cho","year":"2016","unstructured":"Cho, Y. J., Lee, S. Y., Kim, T. K., Hong, D. M. & Jeon, Y. Effect of prewarming during Induction of Anesthesia on Microvascular Reactivity in Patients Undergoing Off-Pump Coronary Artery Bypass Surgery: A Randomized Clinical Trial. PLoS ONE 11, e0159772 (2016).","journal-title":"PLoS ONE"},{"key":"52960_CR24","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1213\/00000539-200202000-00034","volume":"94","author":"EP Horn","year":"2002","unstructured":"Horn, E. P. et al. Active warming during cesarean delivery. Anesth Analg. 94, 409\u201314 (2002).","journal-title":"Anesth Analg."},{"key":"52960_CR25","doi-asserted-by":"publisher","first-page":"454","DOI":"10.4097\/kjae.2012.62.5.454","volume":"62","author":"SH Chung","year":"2012","unstructured":"Chung, S. H. et al. Effect of preoperative warming during cesarean section under spinal anesthesia. Korean J Anesthesiol. 62, 454\u201360 (2012).","journal-title":"Korean J Anesthesiol."},{"key":"52960_CR26","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1213\/ANE.0000000000002026","volume":"126","author":"J Munday","year":"2018","unstructured":"Munday, J. et al. Preoperative warming versus no preoperative warming for maintenance of normothermia in women receiving intrathecal morphine for cesarean delivery: A single-blinded, randomized controlled trial. Anesth Analg. 126, 183\u20139 (2018).","journal-title":"Anesth Analg."},{"key":"52960_CR27","first-page":"2366","volume":"12","author":"YY Jo","year":"2015","unstructured":"Jo, Y. Y., Chang, Y. J., Kim, Y. B., Lee, S. & Kwak, H. J. Effect of preoperative forced-air warming on hypothermia in elderly patients undergoing transurethral resection of the prostate. Urol J. 12, 2366\u201370 (2015).","journal-title":"Urol J."},{"key":"52960_CR28","doi-asserted-by":"publisher","first-page":"1029","DOI":"10.1007\/s12630-018-1161-8","volume":"65","author":"A Lau","year":"2018","unstructured":"Lau, A. et al. Effect of preoperative warming on intraoperative hypothermia: a randomized-controlled trial. Can J Anaesth. 65, 1029\u201340 (2018).","journal-title":"Can J Anaesth."},{"key":"52960_CR29","doi-asserted-by":"publisher","first-page":"531","DOI":"10.1097\/00000542-200108000-00040","volume":"95","author":"DI Sessler","year":"2001","unstructured":"Sessler, D. I. Complications and treatment of mild hypothermia. Anesthesiology. 95, 531\u201343 (2001).","journal-title":"Anesthesiology."},{"key":"52960_CR30","doi-asserted-by":"publisher","first-page":"214","DOI":"10.1097\/00000542-199308000-00004","volume":"79","author":"B Just","year":"1993","unstructured":"Just, B., Tr\u00e9vien, V., Delva, E. & Lienhart, A. Prevention of intraoperative hypothermia by preoperative skin-surface warming. Anesthesiology. 79, 214\u20138 (1993).","journal-title":"Anesthesiology."},{"key":"52960_CR31","doi-asserted-by":"publisher","first-page":"488","DOI":"10.1213\/00000539-199309000-00012","volume":"77","author":"B Glosten","year":"1993","unstructured":"Glosten, B., Hynson, J., Sessler, D. I. & McGuire, J. Preanesthetic skin-surface warming reduces redistribution hypothermia caused by epidural block. Anesth Analg. 77, 488\u201393 (1993).","journal-title":"Anesth Analg."},{"key":"52960_CR32","doi-asserted-by":"publisher","first-page":"384","DOI":"10.1016\/0952-8180(95)00051-I","volume":"7","author":"Y Camus","year":"1995","unstructured":"Camus, Y., Delva, E., Sessler, D. I. & Lienhart, A. Pre-induction skin-surface warming minimizes intraoperative core hypothermia. J Clin Anesth. 7, 384\u20138 (1995).","journal-title":"J Clin Anesth."},{"key":"52960_CR33","doi-asserted-by":"publisher","first-page":"829","DOI":"10.1213\/ANE.0b013e3181cb3ebf","volume":"110","author":"JL De Witte","year":"2010","unstructured":"De Witte, J. L., Demeyer, C. & Vandemaele, E. Resistive-heating or forced-air warming for the prevention of redistribution hypothermia. Anesth Analg. 110, 829\u201333 (2010).","journal-title":"Anesth Analg."},{"key":"52960_CR34","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1016\/j.ejcts.2005.12.020","volume":"29","author":"JY Kim","year":"2006","unstructured":"Kim, J. Y. et al. The effect of skin surface warming during anesthesia preparation on preventing redistribution hypothermia in the early operative period of off-pump coronary artery bypass surgery. Eur J Cardiothorac Surg. 29, 343\u20137 (2006).","journal-title":"Eur J Cardiothorac Surg."},{"key":"52960_CR35","doi-asserted-by":"publisher","first-page":"627","DOI":"10.1093\/bja\/aen272","volume":"101","author":"J Andrzejowski","year":"2008","unstructured":"Andrzejowski, J., Hoyle, J., Eapen, G. & Turnbull, D. Effect of prewarming on post-induction core temperature and the incidence of inadvertent perioperative hypothermia in patients undergoing general anaesthesia. Br J Anaesth. 101, 627\u201331 (2008).","journal-title":"Br J Anaesth."},{"key":"52960_CR36","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1186\/1471-2253-15-8","volume":"15","author":"KM Shin","year":"2015","unstructured":"Shin, K. M. et al. The efficacy of pre-warming on reducing intraprocedural hypothermia in endovascular coiling of cerebral aneurysms. BMC Anesthesiol. 15, 8 (2015).","journal-title":"BMC Anesthesiol."},{"key":"52960_CR37","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1016\/j.jclinane.2016.06.030","volume":"34","author":"A Torossian","year":"2016","unstructured":"Torossian, A. et al. Active perioperative patient warming using a self-warming blanket (BARRIER EasyWarm) is superior to passive termal insulation a multinatinal, multicenter, randoimized trial. J Clin Anesth. 34, 547\u201354 (2016).","journal-title":"J Clin Anesth."},{"key":"52960_CR38","doi-asserted-by":"publisher","first-page":"612","DOI":"10.1111\/j.1365-2044.2012.07073.x","volume":"67","author":"EP Horn","year":"2012","unstructured":"Horn, E. P. et al. The effect of short time periods of pre-operative warming in the prevention of peri-operative hypothermia. Anaesthesia. 67, 612\u20137 (2012).","journal-title":"Anaesthesia."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-019-52960-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-019-52960-6","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-019-52960-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,17]],"date-time":"2022-12-17T15:45:11Z","timestamp":1671291911000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-019-52960-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,11,11]]},"references-count":38,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2019,12]]}},"alternative-id":["52960"],"URL":"https:\/\/doi.org\/10.1038\/s41598-019-52960-6","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,11,11]]},"assertion":[{"value":"7 May 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 October 2019","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 November 2019","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"16477"}}