Comparison of zero heat flux and double sensor thermometers during spinal anaesthesia: a prospective observational study

Sirkka-Liisa Lauronen, Maija-Liisa Kalliomäki, Jarkko Kalliovalkama, Antti Aho, Heini Huhtala, Arvi M Yli-Hankala, Marja-Tellervo Mäkinen, Sirkka-Liisa Lauronen, Maija-Liisa Kalliomäki, Jarkko Kalliovalkama, Antti Aho, Heini Huhtala, Arvi M Yli-Hankala, Marja-Tellervo Mäkinen

Abstract

Because of the difficulties involved in the invasive monitoring of conscious patients, core temperature monitoring is frequently neglected during neuraxial anaesthesia. Zero heat flux (ZHF) and double sensor (DS) are non-invasive methods that measure core temperature from the forehead skin. Here, we compare these methods in patients under spinal anaesthesia. Sixty patients scheduled for elective unilateral knee arthroplasty were recruited and divided into two groups. Of these, thirty patients were fitted with bilateral ZHF sensors (ZHF group), and thirty patients were fitted with both a ZHF sensor and a DS sensor (DS group). Temperatures were saved at 5-min intervals from the beginning of prewarming up to one hour postoperatively. Bland-Altman analysis for repeated measurements was performed and a proportion of differences within 0.5 °C was calculated as well as Lin`s concordance correlation coefficient (LCCC). A total of 1261 and 1129 measurement pairs were obtained. The mean difference between ZHF sensors was 0.05 °C with 95% limits of agreement - 0.36 to 0.47 °C, 99% of the readings were within 0.5 °C and LCCC was 0.88. The mean difference between ZHF and DS sensors was 0.33 °C with 95% limits of agreement - 0.55 to 1.21 °C, 66% of readings were within 0.5 °C and LCCC was 0.59. Bilaterally measured ZHF temperatures were almost identical. DS temperatures were mostly lower than ZHF temperatures. The mean difference between ZHF and DS temperatures increased when the core temperature decreased.Trial registration: The study was registered in ClinicalTrials.gov on 13th May 2019, Code NCT03408197.

Keywords: Double sensor; Non-invasive core temperature measurement; Spinal anaesthesia; Zero heat flux.

Conflict of interest statement

The authors have no relevant financial or non-financial interests to disclose.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
Flow diagram
Fig. 2
Fig. 2
Bland–Altman plot of the ZHF group. Comparison of bilateral ZHF sensors. ZHF zero heat flux, R right forehead, L left forehead, LoA 95% limits of agreement, CI confidence interval
Fig. 3
Fig. 3
Chronological temperature changes of the right and left ZHF sensors. Mean with standard deviation. ZHF zero heat flux, R sensor placed on the right side of the forehead, L sensor placed on the left side of the forehead
Fig. 4
Fig. 4
Bland–Altman plot of the DS group. Comparison of ZHF and DS temperature measurement methods. ZHF zero heat flux, R right forehead, DS double sensor, LoA 95% limits of agreement, CI confidence interval
Fig. 5
Fig. 5
Chronological temperature changes of the ZHF-R and DS sensors. Mean with standard deviation. ZHF-R zero heat flux sensor placed on the right forehead, DS double sensor placed on the left forehead

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