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麻醉期间影响婴幼儿和新生儿意外低体温的危险因素。

Risk factors influencing inadvertent hypothermia in infants and neonates during anesthesia.

作者信息

Tander Burak, Baris Sibel, Karakaya Deniz, Ariturk Ender, Rizalar Riza, Bernay Ferit

机构信息

Department of Pediatric Surgery, Ondokuz Mayis University, Samsun, Turkey.

出版信息

Paediatr Anaesth. 2005 Jul;15(7):574-9. doi: 10.1111/j.1460-9592.2005.01504.x.

Abstract

BACKGROUND

The factors affecting the thermal status in neonates and infants undergoing general anesthesia are not yet investigated in detail. We evaluated the factors leading to intraoperative hypothermia in 60 neonates and infants.

METHODS

The initial body temperatures and the core temperatures at the 10th, 30th, 60th and 90th minute of anesthesia, as well as at the end of the operation were recorded. The patients were divided into the groups according to the age, type of surgery (minor vs major), operating room (OR) temperatures (low '<23 degrees C' vs high '>23 degrees C') and the initial core temperature of the patients.

RESULTS

In 31 neonates and 29 infants, the mean core temperatures decreased 10 min after anesthesia induction. In all neonates and in infants with 'low OR temperature' (<23 degrees C), these decreases continued to the end of the surgery. Except infants undergoing minor surgery, in all patients, the core temperatures at the end of surgery were lower than the baseline temperature. The greatest decrease in core temperatures occurred in neonates undergoing major surgery and with low OR temperature. In low OR temperature, the decrease of core temperature is higher in patients with major surgery. In patients undergoing minor surgery, the decrease of core temperature is more in neonates than infants. Major surgery increased the chance of decrease of the core temperature by 2.66 times and operating room temperature less than 23 degrees C by 1.96 times.

CONCLUSION

The type of surgery and the OR temperature are the main factors for decrease of the core temperature in neonates and infants. In neonates, the core temperatures are less stable, regardless of OR temperature and type of surgery. In high OR temperature, infants can stabilize their core temperature better than neonates.

摘要

背景

影响接受全身麻醉的新生儿和婴儿体温状况的因素尚未得到详细研究。我们评估了60例新生儿和婴儿术中体温过低的相关因素。

方法

记录患者的初始体温以及麻醉第10、30、60和90分钟时及手术结束时的核心体温。根据年龄、手术类型(小手术与大手术)、手术室(OR)温度(低“<23摄氏度”与高“>23摄氏度”)和患者的初始核心体温对患者进行分组。

结果

在31例新生儿和29例婴儿中,麻醉诱导后10分钟平均核心体温下降。在所有新生儿以及手术室温度低(<23摄氏度)的婴儿中,这些下降持续至手术结束。除接受小手术的婴儿外,所有患者手术结束时的核心体温均低于基线体温。核心体温下降幅度最大的是接受大手术且手术室温度低的新生儿。在手术室温度低时,大手术患者的核心体温下降幅度更大。在接受小手术的患者中,新生儿的核心体温下降幅度大于婴儿。大手术使核心体温下降的几率增加2.66倍,手术室温度低于23摄氏度使核心体温下降的几率增加1.96倍。

结论

手术类型和手术室温度是新生儿和婴儿核心体温下降的主要因素。在新生儿中,无论手术室温度和手术类型如何,核心体温都较不稳定。在手术室温度高时,婴儿比新生儿能更好地稳定其核心体温。

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