Kim Eun Ju, Yoon Haesang
Author Affiliations: Nurse Anesthetist (Ms Kim), Gachon University Gil Hospital; and Professor (Dr Yoon), College of Nursing, Gachon University, Incheon, Republic of Korea.
Clin Nurse Spec. 2014 Sep-Oct;28(5):268-76. doi: 10.1097/NUR.0000000000000069.
The study was conducted to identify preoperative factors affecting the intraoperative core body temperature in abdominal surgery under general anesthesia.
This study was performed through prospective descriptive research design.
The setting was a 1300-bed university hospital in Incheon, South Korea.
The sample consisted of 147 patients who had undergone elective abdominal surgery under general anesthesia.
Age, weight, and height were collected on a preoperative visit to general unit, and body mass index, body surface area, and total body fat were calculated. The basal preoperative core body temperature (CBT), preoperative blood pressure, and heart rate were measured. Core body temperature was again measured at 1, 2, and 3 hours following general anesthesia.
Predictive factors of intraoperative hypothermia of less than 36°C were preoperative CBT (β = .44), weight (β = .41), preoperative heart rate (β = .20), and age (β = -.13) at 1 hour after anesthesia (R = 0.658, F = 68.3, P < .001); preoperative CBT (β = .33), weight (β = .37), preoperative heart rate (β = .22), and age (β = -.24) at 2 hours after anesthesia (R = 0.631, F = 60.8, P < .001); and age (β = -.34), weight (β = .36), preoperative CBT (β = .30), and preoperative heart rate (β = .20) at 3 hours after anesthesia (R = 0.665, F = 70.6, P < .001).
Low preoperative body temperature and low weight seem to be risk factors of intraoperative hypothermia during 2 hours after anesthesia and advanced age and low weight at 3 hours following anesthesia.
We recommend prewarming and intraoperative warming through forced air warming devices and covering a patient with a warm blanket during transportation. This procedure is necessary for the abdominal surgical patients of advanced age with low weight and duration of general anesthesia to last more than 1 hour.
本研究旨在确定影响全身麻醉下腹部手术术中核心体温的术前因素。
本研究采用前瞻性描述性研究设计。
研究地点为韩国仁川一家拥有1300张床位的大学医院。
样本包括147例行全身麻醉下择期腹部手术的患者。
在术前到普通病房就诊时收集年龄、体重和身高，并计算体重指数、体表面积和体脂总量。测量术前基础核心体温（CBT）、术前血压和心率。全身麻醉后1、2和3小时再次测量核心体温。
麻醉后1小时，术中体温低于36°C的预测因素为术前CBT（β = 0.44）、体重（β = 0.41）、术前心率（β = 0.20）和年龄（β = -0.13）（R = 0.658，F = 68.3，P < 0.001）；麻醉后2小时，术前CBT（β = 0.33）、体重（β = 0.37）、术前心率（β = 0.22）和年龄（β = -0.24）（R = 0.631，F = 60.8，P < 0.001）；麻醉后3小时，年龄（β = -0.34）、体重（β = 0.36）、术前CBT（β = 0.30）和术前心率（β = 0.20）（R = 0.665，F = 70.6，P < 0.001）。
术前体温低和体重低似乎是麻醉后2小时内术中体温过低的危险因素，而高龄和麻醉后3小时体重低是危险因素。
我们建议通过强制空气加热装置进行术前预热和术中加热，并在转运过程中用温暖的毯子覆盖患者。对于年龄较大、体重低且全身麻醉持续时间超过1小时的腹部手术患者，此程序是必要的。
Zotero 插件