Perioperative Hypothermia Prevention — FRCA Final MCQ

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EasyPerioperative MedicinePerioperative Hypothermia PreventionFRCA Final

A 68-year-old woman (ASA III) is undergoing a Whipple procedure. She has a thoracic epidural at T7/8 and is receiving 0.125% bupivacaine with fentanyl 2 mcg/mL at 8 mL/hr. Her temperature drops to 34.8°C. Which is the most effective method of intraoperative warming?

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Correct answer: D — Forced warm air blankets

Forced warm air devices (e.g., Bair Hugger) are the most effective method of active patient warming during surgery, reducing heat loss by convection and conduction. NICE CG65 recommends maintaining patient temperature ≥36°C throughout anaesthesia. Perioperative hypothermia increases surgical site infection risk (by 300%), coagulopathy, cardiac events, drug metabolism changes, and shivering. IV fluid warming prevents further heat loss but does not actively warm. Epidural-induced vasodilation increases heat redistribution from core to periphery.

Reference: NICE – 2016 – CG65 Perioperative hypothermia prevention; RCOA – 2023 – Perioperative care