الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
This study was carried out on 40 adult patients of both sexes who were classified according to the American Society of Anesthesiologists ( ASA ) in relation to their clinical status as ASA II or III and scheduled for elective long timed major pelvi-abdominal operations ( 2, 3 ) i.e for more than 90 minutes ( e.g: radical cystectomy, radical nephrectomy total or subtotal colectomy and open prostatectomy ) in Alexandria Main University hospital .An approval from the hospital human studies committee and informed consent from the patients were obtained .We have divided the patients into two studied groups : Group I : (control group): Patients were exposed to the effect of the routine thermal care without active warming techniques e.g : adequate surgical draping ( at least two layers of warmed cotton blankets ) and warming of intravenous fluids .Group II : ( warming group ) : Patients were undergoing active warming techniques e.g: warming of intra-operative fluids to 37 [degree sign]C., warming blanket ( Warm touch – Malinckroditt ) which is an upper-body forced-air cover, delivers air at 40 [degree sign]C and adequate surgical draping .All patients included in this study were assessed pre-operatively as follows :
• Careful history taking
• Thorough clinical examination for all body systems, assessment of nutritional status and verification of ASA status of the patiens .
• Routine pre-operative laboratory investigations
• Specific pre-operative investigations :
I ) Immune response :
Interleukine I ( beta sub unit ) and interleukine II, Macrophage migration and White blood cell count .
II ) Stress response base line value : by serum cortisol level .
III) Haemoestatic profile :
1- Platelets function by Adenosine Di-phosphate technique, Fibrin degradation products ( FDPs ) and Bleeding profile : ( prothrombine time and activity (PT), activated partial thromboplastine time (aPTT) , bleeding time ( BT ) and INR .
Anaesthetic technique:
- Confirmation of medical history, laboratory investigations and clinical examination, a large gauge peripheral intravenous line was inserted .
- Basic non invasive intra-operative monitors will be connected ( electro-cardiogram ECG, non invasive blood pressure NIBP cuff, pulse oximeter and monitoring of core body temperature by a tympanic probe ) .