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麻醉技术和环境温度对下肢手术中体温调节的影响。

The effects of anesthetic technique and ambient temperature on thermoregulation in lower extremity surgery.

机构信息

Department of Anesthesiology and Reanimation, Faculty of Medicine, Firat University, Elazig, 23119, Turkey.

出版信息

J Anesth. 2013 Aug;27(4):528-34. doi: 10.1007/s00540-013-1555-2. Epub 2013 Jan 23.

Abstract

PURPOSE

The purpose of our study was to determine the effects of anesthetic technique and ambient temperature on thermoregulation for patients undergoing lower extremity surgery.

METHODS

Our study included 90 male patients aged 18-60 years in American Society of Anesthesiologists Physical Status groups I or II who were scheduled for lower extremity surgery. Patients were randomly divided into three groups according to anesthetic technique: general anesthesia (GA), epidural anesthesia (EA), and femoral-sciatic block (FS). These groups were divided into subgroups according to room temperature: the temperature for group I was 20-22 °C and that for group II was 23-25 °C. Therefore, we labeled the groups as follows: GA I, GA II, EA I, EA II, FS I, and FS II. Probes for measuring tympanic membrane and peripheral temperature were placed in and on the patients, and mean skin temperature (MST) and mean body temperature (MBT) were assessed. Postoperative shivering scores were recorded.

RESULTS

During anesthesia, tympanic temperature and MBT decreased whereas MST increased for all patients. There was no significant difference between tympanic temperatures in either the room temperature or anesthetic method groups. MST was lower in group GA I than in group GA II after 5, 10, 15, 20, 60 and 90 min whereas MBT was significantly lower at the basal level (p < 0.05). MST after 5 min was significantly lower in group GA I than in group FS I (p < 0.05). Shivering score was significantly higher in group GA I (p < 0.05).

CONCLUSIONS

There were no significant differences in thermoregulation among anesthetic techniques. Room temperature affected thermoregulation in Group GA.

摘要

目的

本研究旨在确定麻醉技术和环境温度对接受下肢手术患者体温调节的影响。

方法

本研究纳入了 90 名年龄在 18-60 岁之间、ASA 身体状况 I 或 II 级的男性患者,他们计划接受下肢手术。患者根据麻醉技术随机分为三组:全身麻醉(GA)、硬膜外麻醉(EA)和股-坐骨神经阻滞(FS)。这些组根据室温进一步分为亚组:I 组的温度为 20-22°C,II 组的温度为 23-25°C。因此,我们将这些组标记为:GA I、GA II、EA I、EA II、FS I 和 FS II。在患者体内和体表放置测量鼓膜和外周温度的探头,并评估平均皮肤温度(MST)和平均体温(MBT)。记录术后寒战评分。

结果

在麻醉过程中,所有患者的鼓膜温度和 MBT 均下降,而 MST 升高。室温或麻醉方法组之间鼓膜温度无显著差异。与 GA II 组相比,GA I 组在 5、10、15、20、60 和 90 分钟时 MST 较低,而 MBT 在基础水平显著较低(p<0.05)。与 FS I 组相比,GA I 组在 5 分钟时 MST 显著较低(p<0.05)。GA I 组的寒战评分显著较高(p<0.05)。

结论

麻醉技术之间的体温调节无显著差异。室温会影响 GA 组的体温调节。

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