Effectiveness of forced air warming and infusion of high dose of amino acid solution on intraoperative hypothermia and coagulation dysfunction in patients undergoing head and neck cancer surgeries: A prospective randomized non-inferiority study

Induction of anaesthesia isuniversally associated with hypothermia due to loss of normal thermoregulatorymechanism. This rapid fall in core temperature during first hour is followed bya gradual and constant decline in core temperature. Even mild hypothermia maybe deleterious to the patient outcome because of associated myocardial ischemia,4 prolonged drug actions, 5 coagulopathy6 andshivering.  So we decided to conduct thisstudy to compare the effects of external heating (forced air warming system)and internal heat generation (amino acid infusion) in preventing hypothermiaduring anesthesia.

After institutional research committee’sapproval this prospective, randomized, study will be conducted in 75ASA Grade –I/II patients of either sex in the age group of 20 to 65 years admitted forelective cancer surgery under general anesthesia. The patients will berandomized into two  groups GroupAA4      (N=50): Amino Acid infusion @ 4ml/kg/hrand Group FA (N=50): forced air warming system will be applied. All the patients will be covered with the drapes. Intravenousfluids via fluid warmer will be given as per requirement.   All the patients will be hooked tostandard monitors in the operating room and anesthesia will be induced withPropofol 2mg/kg. Airway will be secured after injection vecuronium bromide(0.1mg/kg). The core temperature of the patients will be recorded pre inductionand every 20 minutes thereafter. OT temperature, meanintraoperative temperature, presence of intraoperative hypothermia, operativetime, use of blood products, total fluids infused, platelet and coagulationfunction  as assessed bythrombo-elastograph and oxygen debt will be noted. The data thuscollected will be expressed as a number or mean ± standard deviation. Patientcharacteristics will be compared with chi-squaretest. Appropriate tests will be applied for other data and the degree ofhypothermia will be correlated with various variables.