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Prewarming of surgical patients to prevent hypotension on induction of anaesthesia

Prewarming of neurosurgical patients to prevent hypotension on induction of anaesthesia

Status
Completed
Phases
Unknown
Study type
Interventional
Source
ANZCTR
Registry ID
ACTRN12615000431527
Enrollment
32
Registered
2015-05-06
Start date
2015-01-29
Completion date
2015-06-22
Last updated
2020-01-13

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

None listed

Brief summary

General anaesthesia, whilst very safe, has some undesirable side effects. Two of these, a fall in body temperature and a fall in blood pressure, are usually very mild and require little treatment. Occasionally, more severe changes can result requiring significant intervention by the anaesthetist. Whilst prewarming of patients prior to surgery is sometimes employed to reduce the drop in body temperature seen with anaesthesia, it is not known whether this warming may also help reduce the fall in blood pressure. Warming patients results in dilation of blood vessels, with some of the circulating blood volume then moving into more peripheral tissues. This is similar to the process that happens under anaesthesia, with the relaxation of blood vessels caused by anaesthetic drugs resulting in lowered blood pressure. This is usually mild and easily correctable with medications and intravenous fluid administered by the anaesthetist, though occasionally can be more serious. This study aims to answer the question of whether prewarming patients may reduce the fall in blood pressure seen with the onset of anaesthesia, due to blood vessels already being dilated, and hence reduce the need for intervention by the anaesthetist.

Interventions

Prewarming of neurosurgical patients for one hour at 46 degrees Celsius with a forced air warmer (Cocoon Convective Warming System 4000, Care Essentials, North Geelong, Victoria, Australia) prior to anaesthetic induction, after placement of intra-arterial blood pressure monitoring. The patient's temperature is measured prior to and at conclusion of warming

Sponsors

Jai Darvall
Lead SponsorIndividual

Study design

Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Prevention
Masking
Blinded (masking used) (Outcomes Assessor)

Eligibility

Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

1. Neurosurgical patients aged 18 years and over 2. Craniotomy for any indication 3. American Society of Anesthesiologists’ (ASA) physical status 1-3

Exclusion criteria

1. Inadequate English comprehension due to a language barrier, cognitive deficit or intellectual disability 2. Significant cardiorespiratory impairment (i.e. ASA 4-5 patients) 3. Severe hypertension (systolic BP > 180 mmHg, diastolic BP > 110 mmHg in the operating suite admission bay) 4. Antihypertensive therapy with ACE inhibitor/angiotensin II receptor antagonist if administered on the day of surgery 5. Secondary hypertension (e.g. renal artery stenosis, phaeochromocytoma, Cushing's syndrome) 6. Temperature > 37.5 degrees Celcius at baseline 7. Thyroid dysfunction 8. Otitis media/externa (preventing accurate tympanic membrane temperature measurement)

Outcome results

None listed

Source: ANZCTR · Data processed: Mar 9, 2026