Effect of a combined thermal protection strategy with plantar hot salt packs on preventing intraoperative hypothermia during knee arthroscopy: a randomized controlled trial

This study aimed to evaluate the efficacy of a combined thermal protection strategy incorporating plantar hot salt packs for preventing intraoperative hypothermia in patients undergoing knee arthroscopy. This randomized controlled trial enrolled 120 patients undergoing knee arthroscopy between January 2024 and December 2024. Patients were randomly assigned to either the experimental group (n = 60), which received routine care plus plantar hot salt packs, or the control group (n = 60), which received routine thermal care alone. The primary outcome was core body temperature, recorded at the following time points: admission (T0), 15 min after anesthesia induction (T1),3 0 min after surgery initiation (T2), at the end of surgery (T3), and upon arrival in the anesthesia recovery room (T4). Secondary outcomes included the incidence of intraoperative hypothermia, postoperative chills, patient comfort, and satisfaction. After adjusting for baseline temperature (T0) using analysis of covariance (ANCOVA), the experimental group maintained significantly higher core body temperatures at T1, T2, T3, and T4 than the control group (all adjusted P < 0.001). No significant between-group differences were observed in the incidence of intraoperative hypothermia or postoperative chills (both P > 0.05). Patient comfort was significantly higher in the experimental group (P < 0.05). Although patient satisfaction was numerically higher in the experimental group (98.3% vs. 88.3%), the difference was not statistically significant (P = 0.061). A combined thermal protection strategy using plantar hot salt packs effectively maintains perioperative core body temperature and significantly improves patient comfort during knee arthroscopy. While this strategy did not significantly reduce the incidence of hypothermia or chills, it represents a safe, non-invasive, and easily implemented adjunctive warming method that may help optimize intraoperative temperature management. Trial registration: Chinese Clinical Trial Registry, ChiCTR2600120304 (registered March 12, 2025).