Effects of Forced Air Warming Vs Fluid Warming on Maternal and Neonatal Outcomes during Caesarean Section under Spinal Anaesthesia

Background: Preventing inadvertent hypothermia during Caesarean section under spinal anaesthesia is a common challenge.Patients and Methods: One hundred and twelve ASAI and II patients scheduled for elective Caesarean delivery under spinal anaesthesia were randomly allocated to four groups - Group F (warm intravenous fluid at 42oC), A(forced warm air at 37.8oC), B (a combination of F and A)and C (control group - intravenous fluid at 29.8oC).Maternal core temperature was measured intermittently at the tympanic membrane and shivering graded. Neonatal Apgar scores and umbilical venous blood pH were measured across the groups and recorded.Results: Maternal socio demographic variables were similar across the groups. The mean maternal core temperature at the end of surgery in the four groups were; 36.60 ± 0.40 (Group A), 36.90 ± 0.45 (Group B), 36.67 ± 0.35 (Group C) and 36.67 ± 0.35 (Group F) (p = 0.025). The change in maternal core temperature was -0.39 ± 0.350C in group F, -0.57 ± 0.360C in group A,-0.20 ± 0.510C in group B and -0.41 ± 0.440C in group C (p = 0.013). Thermal comfort differed significantly across groups (p = 0.021) with Group Areporting the highest thermal comfort While four patients in group C, 2 each in groups A& F and 1 in group B shivered, 14 parturients were hypothermic. Neonatal Apgar scores and umbilical cord blood pH were comparable across all the groups.Conclusion: At ambient temperature between 21oC and 24oC, forced warm air and warmed intravenous fluid significantly prevented perioperative hypothermia, with no effect on neonatal outcome. Key words: Forced air warming, inadvertent perioperative hypothermia, Caesarean section, spinal anaesthesia