Department of Anesthesiology and Intensive Care, OLV-Hospital, Aalst, Belgium.
Anesth Analg. 2010 Mar 1;110(3):829-33. doi: 10.1213/ANE.0b013e3181cb3ebf. Epub 2009 Dec 30.
We evaluated the efficacy of resistive-heating or forced-air warming versus no prewarming, applied before induction of anesthesia for prevention of hypothermia.
Twenty-seven patients scheduled for laparoscopic colorectal surgery were randomized into 1 of 3 groups: no prewarming; 30 minutes of prewarming with a carbon fiber total body cover at 42 degrees C; or 30 minutes of preoperative forced-air warming at 42 degrees C. The forced-air warming cover excluded the shoulders, ankles, and feet. The prewarming period was exactly 30 minutes. At the 31st minute, a total IV anesthesia technique was initiated, and all patients were actively warmed with a lithotomy blanket. Tympanic and distal esophageal temperatures were measured. Categorical data were analyzed using chi(2) test, and continuous data were analyzed with analysis of variance. P <0.05 was considered statistically significant.
The mean esophageal temperatures differed significantly between the control and the carbon fiber group from 40 to 90 minutes of anesthesia. After 50 minutes of anesthesia, the mean esophageal temperatures in the control, carbon fiber, and forced-air groups were 35.9 degrees C +/- 0.3 degrees C, 36.5 degrees C +/- 0.4 degrees C, and 36.2 degrees C +/- 0.3 degrees C, respectively. No statistically significant difference was found between the forced-air and control groups. After 30 minutes of prewarming with resistive heating, patients had an esophageal temperature that was significantly higher than the control group.
Prewarming should be considered part of the anesthetic management when patients are at risk for postoperative hypothermia.
我们评估了在麻醉诱导前应用电阻加热或强制空气加热与不预热相比预防低体温的效果。
27 名计划行腹腔镜结直肠手术的患者随机分为 3 组:无预热;42°C 碳纤维全身覆盖物预热 30 分钟;或术前 42°C 强制空气预热 30 分钟。强制空气加热覆盖物不包括肩部、脚踝和脚部。预热期正好 30 分钟。在第 31 分钟,开始进行全身静脉麻醉技术,所有患者均使用截石位毯子积极升温。测量鼓室和远端食管温度。使用卡方检验分析分类数据,使用方差分析分析连续数据。P<0.05 被认为具有统计学意义。
麻醉 40-90 分钟时,对照组和碳纤维组的食管温度差异有统计学意义。麻醉 50 分钟后,对照组、碳纤维组和强制空气组的平均食管温度分别为 35.9°C±0.3°C、36.5°C±0.4°C和 36.2°C±0.3°C。强制空气组与对照组之间无统计学差异。电阻加热预热 30 分钟后,患者的食管温度明显高于对照组。
当患者有术后低体温风险时,应考虑预热作为麻醉管理的一部分。