Regional Anesthesia Lower-Body Warming and Postoperative Temperature in Cesarean Delivery Under Spinal Anesthesia: A Randomized Controlled Trial

S. Haim, B. Cohen, A. Lustig, C. Greenberger, B. Aptekman, C. Weiniger

Obstetric Anesthesia Digest, 2025

Abstract

(Int J Obstet Anesth. 58;2024:103990. https://doi.org/10.1016/j.ijoa.2024.103990)

Perioperative hypothermia and shivering are frequent during cesarean delivery (CD) under spinal anesthesia. Hypothermia occurs in around 60% of cases, which when severe contributes to surgical site infections, cardiac issues, and coagulation disorders. In ∼85% of cases, maternal shivering increases discomfort and oxygen consumption while complicating patient monitoring. Active warming methods, such as warmed intravenous (IV) fluids and maintaining appropriate room temperatures, can help counteract this heat loss. Prewarming using forced-air devices has been shown to reduce both intraoperative hypothermia and shivering in CD patients. However, studies using only intraoperative warming have shown limited benefits. This study aimed to test whether combining intraoperative lower-body forced-air warming with warmed IV fluids would mitigate maternal relative hypothermia during elective CD compared with warmed IV fluids alone.

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