Efficacy of intravenous fluid warmer on prevention of hypothermia in laparoscopic gastrointestinal cancer surgeries during general anesthesia

Abstract

Background & objective: Perioperative hypothermia, if not managed adequately, might lead to increased risk of surgical site infection, decreased drug metabolism, a higher requirement for blood transfusions, and an increased chance of cardiac arrhythmias. Various active and passive methods to prevent hypothermia have been used. This study compared the incidence of hypothermia and shivering between patients receiving warmed intravenous fluids using fluid warmer and room temperature intravenous fluids in patients undergoing gastrointestinal cancer surgeries under general anesthesia.

Methodology: This prospective study was conducted in Shaukat Khanum Memorial Cancer Hospital and Research Centre's Department of Anesthesia and Pain Management, Lahore from January to June 2025. Patients aged 18 to 60 years who were undergoing elective laparoscopic gastrointestinal cancer surgery of duration of more than 2 hours were included. Laparoscopic surgery leading to exploratory laparotomy, severe endocrine, pulmonary, and cardiovascular disorders, and a pre-operative core temperature higher than 37.2 degrees Celsius were excluded. The lottery approach was used to randomly assign patients to either Group A or Group B. Fluid warmers were used to administer intravenous fluids to patients in Group A, whereas intravenous fluids at room temperature were administered to patients in Group B based on their body weight and hydration status (control group). The core body temperature was measured at the end of procedure using a temperature probe and the shivering score was recorded.

Results: In our study, the intravenous fluids using a fluid warmer led to a lower incidence of peri-operative hypothermia (2.38%) compared to the control group (28.57%), and the intravenous fluids using a fluid warmer group experienced significantly less shivering during the peri-operative period (19.05%) than the control group (42.86%).

Conclusion: In conclusion, patients undergoing gastrointestinal cancer surgery can benefit from continuous active warming as it can enhance the quality of postoperative rehabilitation and successfully prevent intraoperative hypothermia and shivering.

Abbreviations: HME: heat and moisture exchanger, PACU: post-anesthesia care unit,

Keywords: Gastrointestinal Cancer Surgeries, intravenous fluid warmer, hypothermia.

Citation: Ejaz H, Ashfaq AD. Efficacy of intravenous fluid warmer on prevention of hypothermia in laparoscopic gastrointestinal cancer surgeries during general anesthesia. Anaesth. pain intensive care 2025;29(9):1234-1239. DOI: 10.35975/apic.v29i9.3059

Received: September 06, 2025; Revised: October 15, 2025; Accepted: October 17, 2025