Intraoperative warming and post-operative XXXX after total knee replacement.

@entity1 @entity73
BACKGROUND: Post-operative @entity73 (POCD) can affect 30% of orthopedic surgery @entity1 . We hypothesized that perioperative temperature has an impact on POCD. METHODS: We included 150 @entity1 over 65 years of age scheduled for total knee replacement under spinal anesthesia. They were randomized to receive standard care (sheet cover) or active warming. Neurocognitive assessment (11 subtests) was performed pre-operatively and at day 4 (three subtests) and 3 months (10 subtests). A control group of 55 nonsurgical @entity1 took the same tests at equivalent times. POCD was defined as an individual score decrease of more than 2 standard deviations (SDs) below the baseline on at least two subtests or 2 SDs in the combined z-score, in both cases using control-adjusted changes. RESULTS: Tympanic temperature declined below 35   C in 88% of standard-care @entity1 ; 25.3% of warmed @entity1 had a temperature >= 36   C. On day 4, 3.2% of standard-care @entity1 and 19.4% of warmed @entity1 had POCD (P=0.0058). At 3 months, there were no between-group differences (standard care, 14.3%; warmed, 6.5%) (P=0.2440). CONCLUSIONS: Perioperative warming was associated with a higher incidence of @entity73 at 4 days after total knee replacement in @entity1 >65 years of age.
