Authors: Kimberger, O.¹; Illievich, U.²; Lenhardt, R.³

Source: Anaesthesia, Volume 62, Number 2, February 2007 , pp. 140-145(6)

Publisher: Wiley-Blackwell

Abstract:

Summary

Skin surface warming of patients not only improves thermal comfort, but has been shown to reduce anxiety in a pre-hospital setting. We tested the hypothesis that pre-operative warming can reduce pre-operative anxiety as effectively as a conventional dose of intravenous midazolam in patients undergoing neurosurgery. We randomly allocated 80 patients to four groups in the pre-operative holding area. Treatment was applied for 30-45 min with (1) passive insulation and placebo; (2) passive insulation and intravenous midazolam (30 μg.kg⁻¹); (3) warming with forced-air and placebo; and (4) warming with forced-air and intravenous midazolam (30 μg.kg⁻¹). Thermal comfort levels (VAS 0-100 mm) and anxiety levels (VAS 0-100 mm, Spielberger State-Trait Anxiety Inventory) were assessed twice: before the designated treatment was started and before induction of anaesthesia. In the midazolam and the midazolam/warming groups, anxiety VAS and Spielberger state anxiety scores decreased by − 19 (95% CI: − 29 to − 9, p < 0.01) and − 10 (95% CI: − 14 to − 6, p < 0.01), respectively. In the warming and the combined groups, thermal VAS increased by + 26 (95% CI: 17-34, p < 0.01). Pre-operative warming did not reduce anxiety VAS (p = 0.11) or Spielberger state anxiety (p = 0.19). The results of our study indicate that pre-operative warming can be recommended solely to improve thermal comfort, not to replace anxiolytic premedication regimens.

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1365-2044.2007.04934.x

Affiliations: 1:  Resident 2:  Professor, Department of Anaesthesia and Intensive Care, Medical University of Vienna, Vienna, Austria 3:  Assistant Professor, Vice-chair for Clinical Affairs, Department of Anaesthesiology and Perioperative Medicine and Outcomes Research Institute; Director, Neurosciences Intensive Care Unit, University of Louisville, KY, USA

Publication date: 2007-02-01

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