Thermal suit in preventing unintentional intraoperative hypothermia during general anaesthesia: a randomized controlled trial

Background Unintentional perioperative hypothermia causes serious adverse effects to surgical patients. Thermal suit (T‐Balance ® ) is an option for passive warming perioperatively. We hypothesized that the thermal suit will not maintain normothermia more efficiently than conventional cotton clothes when also other preventive procedures against unintentional hypothermia are used. Methods One hundred patients were recruited to this prospective, randomized trial. They were allocated to the Thermal Suit group or a Control group wearing conventional hospital cotton clothes. All patients received our institution's standard treatment against unintentional hypothermia including a warming mattress, a forced‐air upper body warming blanket and a warming device for intravenous fluids. Eardrum temperature was measured pre‐operatively. In the operating room and post‐anaesthesia care unit temperatures were measured from four locations: oesophagus, left axilla, dorsal surface of the left middle finger and dorsum of the left foot. The primary outcome measure was temperature change during robotic‐assisted laparoscopic radical prostatectomy. Results The temperatures of 96 patients were analysed. There was no difference in mean core temperatures, axillary temperatures or skin temperatures on the finger between the groups. Only foot dorsum temperatures were significantly lower in the Thermal Suit group. Intraoperative temperature changes were similar in both groups. In the post‐anaesthesia care unit temperature changes were minimal and they did not differ between the groups. Conclusion Provided that standard preventive procedures in maintaining normothermia are effective the thermal suit does not provide any additional benefit over conventional cotton clothes during robotic‐assisted laparoscopic radical prostatectomy.