【罂粟摘要】在麻醉诱导和术中1小时后主动强制空气加温可避免老年患者出现低温
作者:罂粟花
在麻醉诱导和术中1小时后主动强制空气加温可避免老年患者出现低温
贵州医科大学 麻醉与心脏电生理课题组 翻译: 黄岁岁 编辑: 潘志军 审校: 曹莹
背景:该研究旨在探索诱导和术中第一个小时强制空气变暖的最佳温度模型,以防止接受腹腔镜腹部手术的老年患者的体温过高。
方法:218例患者随机分为3组:L组(术中体温设为38°C)、H组(术中体温设为42°C)、LH组(术中体温设为42°C,1h后设为38°C),L组(术中体温设为38°C,n=63),LH组(术中体温设为42°C,然后设为38°C,n=65)。用鼓膜温度计测量术前房间和PACU的核心温度,在手术室记录鼻咽温度探头。围术期体温过低(定义为体温降至<36°C)的发生率被记录为主要结果。以术中麻醉剂用量、苏醒时间、不良事件、热舒适度和满意度评分作为次要结果。
结果:低体温发生率LH组和H组明显低于L组(18.75%和15.62%比44.44%,P<0.001;4.69%和4.69%比20.63%,P<0.05)。L组罗库溴铵麻醉剂量低于其他两组,苏醒时间则相反。L组寒战人数较多,H组出汗较多,热舒适性和满意度评分均以LH组最高。
结论:在麻醉诱导后的第一个小时内,强制空气升温的温度模式设置为42°C,并保持在38°C,是接受持续120 min以上的腹腔镜手术的老年患者的合适选择。
原始文献来源
Jingyu Wang1, Ping Fang1*, Gangqiang Sun1, et al. Effect of active forced air warming during the first hour after anesthesia induction and intraoperation avoids hypothermia in elderly patients.[J].BMC Anesthesiol. 2022 Feb 7;22(1):40.
英文原文
Effect of active forced air warming during the first hour after anesthesia induction and intraoperation avoids hypothermia in elderly patients
Abstract
Background:The study aimed at exploring an optimal temperature model of forced air warming during the first hour after induction and intraoperation to prevent hyperthermia for elderly patients undergoing laparoscopic abdominal surgery.
Method:There were 218 patients that were randomly divided into 3 groups warmed with a forced-air warmer during surgery: Group L (intraoperative warming set to 38 °C, n = 63), Group H (intraoperative warming set to 42 °C, n = 65) and Group LH (intraoperative warming set to 42 °C for the first hour then set to 38 °C, n = 65). Core temperature in the preoperative room and PACU was measured by a tympanic membrane thermometer and in the operation room, a nasopharyngeal temperature probe was recorded. The rate of perioperative hypothermia, defined as a reduction in body temperature to < 36 °C was recorded as the primary outcome. Intraoperative anesthetic dosage, recovery time, adverse events, thermal comfort and satisfaction score were measured as secondary outcome.
Results:The incidence of intraoperative and postoperative hypothermia was significantly lower in Group LH and Group H than Group L (18.75 and 15.62% vs 44.44%, P<0.001; 4.69 and 4.69% vs 20.63%, P<0.05). Anesthetic dosage of rocuronium was lower in Group L than other two groups, with the opposite result of recovery time. The number of patients with shivering was higher in Group L but sweating was higher in Group H. Both of the thermal comfort and satisfaction score was highest in Group LH.
Conclusion:A temperature pattern of forced air warming set at 42 °C during the first hour after anesthesia induction and maintained with 38 °C was a suitable choice for elderly patients undergoing laparoscopic abdominal surgery lasting for more than 120 min.
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