Heat Loss During Procedural Sedation for Endoscopy: A Descriptive Study.

Abstract

Purpose: Little is known about heat loss during procedural sedation. Our descriptive study aimed to examine the pattern and characteristics of heat loss in this population.

Design: Continuous temperature monitoring via a zero-heat-flux device examined heat loss among patients receiving procedural sedation for upper and lower endoscopy procedures.

Methods: Adults receiving procedural sedation for lower and complex upper endoscopic procedures at the study hospital on an outpatient basis were included. Temperature was collected prospectively from the zero-heat-flux device. Demographic and clinical data including shivering and thermal comfort were collected from health records or directly from patients. The Gastrointestinal Endoscopy Satisfaction Questionnaire was completed the next day. Change in body temperature was analyzed using linear mixed-model analysis from induction to the end of procedure.

Findings: Among the 165 participants, mean body temperature declined to below 36 °C at 45 minutes from induction. A linear trend model from induction estimated that for every 15 minutes of procedural sedation, body temperature decreased on average by 0.19 °C [95% confidence interval -0.18, -0.21]. Almost one-third (30%, 45/164) were hypothermic on arrival to first-stage recovery, increasing to 42% (68/163) on arrival to second-stage recovery.

Conclusions: Patients receiving procedural sedation for endoscopic procedures may experience heat loss comparable to the initial phase of general or neuraxial anesthesia. Active warming and continuous temperature monitoring are yet to be implemented in this population.