Matsuzaki Y, Matsukawa T, Ohki K, Yamamoto Y, Nakamura M, Oshibuchi T
Department of Anaesthesia, Saiseikai Shimonoseki General Hospital, Japan.
Br J Anaesth. 2003 May;90(5):689-91. doi: 10.1093/bja/aeg106.
Even mild perioperative hypothermia is associated with several severe adverse effects. Resistive heating has possible advantages compared with other active warming systems because it can heat several fields independently. To assess this new warming system, we measured core temperature in patients during surgery who were warmed with circulating water mattresses, forced air covers or resistive heating covers.
Twenty-four patients undergoing laparoscopic cholecystectomy were randomly assigned to (i) circulating water mattress (38 degrees C), (ii) forced air warming (set to 'medium') or (iii) carbon-fibre resistive warming (38 degrees C). Warming was applied throughout anaesthesia and surgery. The groups were compared using one-way ANOVA and Student-Newman-Keuls tests.
Confounding factors were similar among the groups. Core temperatures in each group decreased for 20 min, but subsequently increased in the forced air and resistive heating groups. There was no significant difference between the forced air and resistive heating groups at any time. In contrast, core temperature in the circulating water group continued to decrease. Consequently, core temperature in the circulating water group was significantly lower than in the other groups 30 min after anaesthetic induction and at later times.
Resistive heating maintains core body temperature as well as forced air heating and both are better than circulating water. Resistive heating offers the advantage of adjustable heating pods.
即使是轻度围手术期低温也与多种严重不良反应相关。与其他主动升温系统相比,电阻加热具有潜在优势,因为它可以独立加热多个部位。为评估这种新型升温系统,我们在手术期间测量了使用循环水床垫、强制空气覆盖物或电阻加热覆盖物进行升温的患者的核心体温。
24例接受腹腔镜胆囊切除术的患者被随机分为三组:(i)循环水床垫组(38摄氏度),(ii)强制空气升温组(设置为“中等”),(iii)碳纤维电阻升温组(38摄氏度)。在整个麻醉和手术过程中进行升温。使用单因素方差分析和Student-Newman-Keuls检验对各组进行比较。
各组间混杂因素相似。每组的核心体温均下降20分钟,但随后强制空气升温组和电阻加热组的核心体温上升。在任何时间点,强制空气升温组和电阻加热组之间均无显著差异。相比之下,循环水组的核心体温持续下降。因此,麻醉诱导30分钟后及之后,循环水组的核心体温显著低于其他组。
电阻加热与强制空气加热一样能维持核心体温,两者均优于循环水加热。电阻加热具有加热单元可调节的优势。