None listed
Conditions
Brief summary
Some women have a caesarean section (abbreviated as CS) to have a baby. The safest anaesthetic for this is with an injection in the mother’s back to make her numb from her breasts down which is called epidural or spinal anaesthesia. CS can be categorised as elective (planned) or emergency (unplanned). Elective CS takes place before the onset of labour (uterine contraction), whereas most emergency CS occurs after labour has started. Hypothermia (a low body temperature) is a common problem during elective CS and consequently active warming is recommended. By contrast, hyperthermia (a high body temperature) is a side effect of epidural pain relief during labour and therefore it is possible that hyperthermia is the dominant problem during emergency CS. The temperature changes during emergency CS are not fully understood. It is important to study temperature changes during CS because hypothermia and hyperthermia can cause problems for her or the baby. Some mothers shiver during CS which is an unpleasant side effect that makes it difficult for mothers to hold their babies and breastfeed shortly after birth. What we know so far is shivering during elective CS is caused by hypothermia and is effectively treated with active warming. During emergency CS, however, shivering occurs at normal or increased body temperatures and therefore active warming is likely inappropriate. At present, body temperature is not routinely checked during CS and therefore it is not possible to tailor temperature regulation strategies to individuals’ needs. In this multicentre cohort study, we will investigate how patterns of body temperature change differ between elective and emergency CSs, and how this relates to shivering. We anticipate that this study will highlight the need to routinely measure body temperature during CS and will be a steppingstone towards personalised temperature management strategies during spinal and epidural anaesthesia.
Interventions
The core temperature will be recorded continuously throughout the caesarean section (CS) journey with a 3M™ Bair Hugger™ core Temperature Monitoring System (BHTMS). The BHTMS has a sensor that is attached to the forehead. BHTMS will be applied in the holding bay while waiting for CS for elective CS patients and either in the birthing suite or at the time of arrival in operating theatre for emergency CS patients.
The first temperature logged by the BHTMS will be recorded as the patient’s baseline
The core temperature will be recorded continuously throughout the caesarean section (CS) journey with a 3M™ Bair Hugger™ core Temperature Monitoring System (BHTMS). The BHTMS has a sensor that is attached to the forehead. BHTMS will be applied in the holding bay while waiting for CS for elective CS patients and either in the birthing suite or at the time of arrival in operating theatre for emergency CS patients. The first temperature logged by the BHTMS will be recorded as the patient’s baseline temperature. Core temperature monitoring with BHTMS is continued in operating theatre during caesarean section and in recovery room. The overall duration of monitoring will be approximately 6 hours from the time of applying BHTMS to leaving the recovery room.
Sponsors
Fiona Stanley Hospital
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
• Elective caesarean section under subarachnoid block (spinal/combined spinal and epidural anaesthesia) • Intrapartum emergency caesarean section under epidural anaesthesia • Age 18 or above
Exclusion criteria
• Patient refusal • Inability to consent • ASA 3 or over • Morbidly obese (BMI 50 or over) • Category 1 or “Code Blue” emergency caesarean section (due to an “urgent threat to the life of the woman or the fetus” as per RANZCOG) • Antepartum haemorrhage requiring blood transfusion • Active warming with air forced blanket and/or fluid warmer are planned to use from the beginning of the caesarean section
Outcome results
None listed