Eyelade Olayinka R, Orimadegun Adebola E, Akinyemi Oluranti A, Tongo Olukemi O, Akinyinka Olusegun O
Department of Anaesthesia, College of Medicine, University of Ibadan, Ibadan, Nigeria.
J Perianesth Nurs. 2011 Jun;26(3):151-9. doi: 10.1016/j.jopan.2011.03.009.
The purpose of this study was to determine the degrees of agreement between various sites of temperature measurement and examine the trend of body temperature in children during surgery under general anaesthesia. Thirty-six consecutive children who underwent surgery with general anaesthesia, had temperatures measured at the oesophagus, skin, ear canal and rectum at baseline, every 15 minutes for the first hour and every 30 minutes thereafter. Spearman correlation and Bland-Altman analyses were used to compare data and trends of mean differences assessed by line graphs. The median age of the sample was 48 months. There were 575 temperature measurements taken. The inter-method correlation coefficients was highest for the oesophageal vs rectal (r = 0.96) temperature and lowest for rectal vs skin (r = -0.11) temperature. The lowest mean difference (95% CI) in temperature at commencement of surgery was between the oesophageal and rectal sites, -0.03°C (-0.08, -0.01) while the highest mean difference (95% CI) temperature was between oesophageal and skin sites, 3.24°C (2.65, 3.85). The trend in differential temperatures between sites remained throughout the duration of surgery. Bland-Altman plots showed that the least difference (bias) at baseline (0.3°C) was between the oesophageal and tympanic temperatures while at 1 hour (0.13°C ) was between the oesophageal and rectal temperatures. The oesophageal site was the closest to rectal for monitoring core temperature while the skin was the least reliable site in the study population. In the situation where oesophageal probe is not routine or functioning, rectal or tympanic temperatures may be used.
本研究的目的是确定全身麻醉下儿童手术期间不同体温测量部位之间的一致性程度，并研究体温变化趋势。36例连续接受全身麻醉手术的儿童，在基线时于食管、皮肤、耳道和直肠测量体温，最初1小时每15分钟测量一次，之后每30分钟测量一次。采用Spearman相关性分析和Bland-Altman分析来比较数据以及通过折线图评估的平均差异趋势。样本的中位年龄为48个月。共进行了575次体温测量。方法间相关系数最高的是食管与直肠温度（r = 0.96），最低的是直肠与皮肤温度（r = -0.11）。手术开始时体温的最低平均差异（95% CI）出现在食管和直肠部位，为-0.03°C（-0.08，-0.01），而最高平均差异（95% CI）出现在食管和皮肤部位，为3.24°C（2.65，3.85）。各部位间温差趋势在手术全过程中持续存在。Bland-Altman图显示，基线时食管与鼓膜温度间的差异（偏差）最小（0.3°C），1小时时食管与直肠温度间的差异（偏差）最小（0.13°C）。在本研究人群中，食管部位是监测核心体温最接近直肠的部位，而皮肤是最不可靠的部位。在食管探头非常规使用或无法正常工作的情况下，可采用直肠或鼓膜温度。
