Journal List > J Korean Acad Nurs > v.47(4) > 1003251

J Korean Acad Nurs. 2017 Aug;47(4):456-466. Korean.
Published online August 31, 2017.
© 2017 Korean Society of Nursing Science
The Effects of 30-Minutes of Pre-Warming on Core Body Temperature, Systolic Blood Pressure, Heart Rate, Postoperative Shivering, and Inflammation Response in Elderly Patients with Total Hip Replacement under Spinal Anesthesia: A Randomized Double-blind Controlled Trial
You Mi Cheon,1 and Haesang Yoon2
1Department of Nursing, Gachon University Gil Medical Center, Incheon, Korea.
2College of Nursing, Gachon University, Incheon, Korea.

Address reprint requests to: Yoon, Haesang. College of Nursing, Gachon University, 191 Hambakmoero, Incheon 21936, Korea. Tel: +82-32-820-4212, Fax: +82-32-820-4201, Email:
Received February 01, 2017; Revised May 22, 2017; Accepted May 22, 2017.

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. ( If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.



This study was designed to determine the effects of pre-warming on core body temperature (CBT) and hemodynamics from the induction of spinal anesthesia until 30 min postoperatively in surgical patients who undergo total hip replacement under spinal anesthesia. Our goal was to assess postoperative shivering and inflammatory response.


Sixty-two surgical patients were recruited by informed notice. Data for this study were collected at a 1,300-bed university hospital in Incheon, South Korea from January 15 through November 15, 2013. Data on CBT, systemic blood pressure (SBP), and heart rate were measured from arrival in the pre-anesthesia room to 3 hours after the induction of spinal anesthesia. Shivering was measured for 30 minutes post-operatively. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were measured pre-operatively, and 1 and 2 days postoperatively. The 62 patients were randomly allocated to an experimental group (EG), which underwent pre-warming for 30 minutes, or a control group (CG), which did not undergo pre-warming.


Analysis of CBT from induction of spinal anesthesia to 3 hours after induction revealed significant interaction between group and time (F=3.85, p=.008). In addition, the incidence of shivering in the EG was lower than that in the CG (χ2=6.15, p=.013). However, analyses of SBP, heart rate, CRP, and ESR did not reveal significant interaction between time and group.


Pre-warming for 30 minutes is effective in increasing CBT 2 and 3 hours after induction of spinal anesthesia. In addition, pre-warming is effective in decreasing post-operative shivering.

Keywords: Hypothermia; Body temperature regulation; Hemodynamics; Shivering; Inflammation


Figure 1
Flow diagram of the study participants.
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Table 2
Baseline Demographic and Clinical Characteristics of Subjects (N=62)
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Table 3
Comparison of Body Temperature, Systolic Blood Pressure, Heart Rate and Shivering between Control and Experimental Groups (N=62)
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Table 4
Comparison of CRP and ESR between Control and Pre-warming Groups (N=62)
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This manuscript is a revision of the first author's master's thesis from Gachon University.

CONFLICTS OF INTEREST:The authors declared no conflict of interest.

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