Intraoperative hypothermia is common during cesarean delivery under spinal anesthesia and contributes to maternal discomfort, shivering, and metabolic stress. Active warming systems such as forced-air warming are recommended in perioperative guidelines; however, their effectiveness in obstetric anesthesia remains variably documented. This randomized controlled trial evaluated whether perioperative forced-air warming reduces maternal hypothermia and shivering during elective cesarean section under spinal anesthesia without adversely affecting neonatal outcomes.
Spinal anesthesia impairs thermoregulation by inhibiting vasoconstriction and redistributing core heat to peripheral compartments. As a result, parturients undergoing cesarean delivery are at increased risk of peri-operative hypothermia (\<36°C). Even mild hypothermia is associated with shivering, increased oxygen consumption, and maternal discomfort. This prospective randomized controlled trial compared preoperative forced-air warming with standard thermal care in term parturients undergoing elective cesarean delivery under spinal anesthesia. The study was conducted between June 2023 and December 2025. A total of 120 participants were enrolled and randomized equally into two groups. Maternal core temperature trends, incidence of hypothermia, shivering, thermal comfort, and neonatal outcomes were analyzed.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
120
Perioperative forced-air warming was administered using a forced-air warming device during elective cesarean delivery under spinal anesthesia to maintain maternal normothermia.
Hamad Medical Corporation
Al Rayyan, Baladiyat ad Dawhah, Qatar
Incidence of maternal hypothermia (<36°C)
Maternal hypothermia is defined as a core body temperature \<36.0°C measured intraoperatively and in the immediate postoperative period.
Time frame: From induction of spinal anesthesia until discharge from the post-anesthesia care unit (approximately 3 hours).
Incidence of Maternal Hypothermia
Maternal hypothermia is defined as a core body temperature of \<36.0°C measured intraoperatively and in the immediate postoperative period.
Time frame: From induction of spinal anesthesia until discharge from the post-anesthesia care unit (approximately 3 hours).
Maternal Shivering Score
Maternal shivering will be assessed using a four-point shivering scale ranging from 0 to 3: 0 = no shivering; 1 = intermittent, low-intensity shivering; 2 = moderate shivering; and 3 = continuous, intense shivering. Higher scores indicate greater severity of shivering.
Time frame: This period extends from the preoperative phase through surgery and into the first hour in the post-anesthesia care unit (PACU).
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