[一种新型保暖毯的疗效:前瞻性随机试验]
[Efficacy of a novel warming blanket: prospective randomized trial].
作者信息
Brandes I F, Müller C, Perl T, Russo S G, Bauer M, Bräuer A
机构信息
Abteilung Anaesthesiologie, Zentrum Anaesthesiologie, Rettungs- und Intensivmedizin, Universitätsmedizin Göttingen, Georg-August-Universität, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland.
出版信息
Anaesthesist. 2013 Feb;62(2):137-42. doi: 10.1007/s00101-013-2140-7.
BACKGROUND
Perioperative hypothermia is a common complication of general anesthesia and occurs in up to 50 % of patients during ear, nose and throat (ENT) surgery. In this prospective, randomized controlled study the hypothesis that a new conductive warming blanket (Barrier® EasyWarm®, Mölnlycke Health Care Erkrath, Germany) is better in reducing the incidence of perioperative hypothermia in ENT surgery than insulation with a conventional hospital duvet alone was tested.
MATERIALS AND METHODS
After approval of the local ethics committee and written informed consent 80 patients with a planned procedure time between 1 and 3 h were recruited. Anesthesia was induced and maintained using propofol, remifentanil and rocuronium and the core temperature was measured using an esophageal temperature probe. Patients in the study group were warmed at least 30 min prior to induction of anesthesia using the novel warming blanket (Barrier® EasyWarm®) and patients in the control group were insulated with a standard hospital duvet. Data were tested using Fisher's exact test, Student's t-test or the Mann-Whitney U-test as appropriate. Time-dependent changes in core temperature were evaluated using repeated measures analysis of variance (ANOVA) and post hoc Scheffé's test. Results are expressed as mean ± SD or as median and interquartile range (IQR) as appropriate. A p < 0.05 was considered to be statistically significant.
RESULTS
The ANOVA did not identify a significantly higher core temperature in the study group at any time point. Furthermore, Fisher's exact test showed no differences in the incidence of intraoperative (12 out of 29 versus 10 out of 32 patients, p = 0.44) or postoperative hypothermia (12 out of 29 versus 9 out of 32 patients, p = 0.30) between the groups. No adverse effects were observed.
CONCLUSIONS
In the studied patient group the new conductive warming blanket (Barrier® EasyWarm®) showed no superiority compared to conventional thermal insulation alone.
背景
围手术期体温过低是全身麻醉常见的并发症,在耳鼻喉(ENT)手术中,高达50%的患者会出现该情况。在这项前瞻性随机对照研究中,对一种新型传导式保暖毯(德国莫林医疗保健公司的Barrier® EasyWarm®)在降低耳鼻喉手术围手术期体温过低发生率方面是否优于仅使用传统医院羽绒被进行保温这一假设进行了测试。
材料与方法
经当地伦理委员会批准并获得书面知情同意后,招募了80名计划手术时间在1至3小时之间的患者。使用丙泊酚、瑞芬太尼和罗库溴铵诱导并维持麻醉,采用食管温度探头测量核心体温。研究组患者在麻醉诱导前至少30分钟使用新型保暖毯(Barrier® EasyWarm®)进行保暖,对照组患者则使用标准医院羽绒被进行保温。根据情况使用Fisher精确检验、Student's t检验或Mann-Whitney U检验对数据进行检验。使用重复测量方差分析(ANOVA)和事后Scheffé检验评估核心体温随时间的变化。结果以均值±标准差或中位数和四分位数间距(IQR)表示。p < 0.05被认为具有统计学意义。
结果
方差分析未发现在任何时间点研究组的核心体温显著更高。此外,Fisher精确检验显示两组之间术中体温过低发生率(29例中有12例,32例中有10例,p = 0.44)或术后体温过低发生率(29例中有12例,32例中有9例,p = 0.30)没有差异。未观察到不良反应。
结论
在所研究的患者组中,新型传导式保暖毯(Barrier® EasyWarm®)与仅使用传统保温措施相比没有优势。