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局部麻醉下眼手术中使用强制空气加热毯对患者呼气末和经皮二氧化碳分压的影响:一项单盲、随机对照试验。

The effect of a forced-air warming blanket on patients' end-tidal and transcutaneous carbon dioxide partial pressures during eye surgery under local anaesthesia: a single-blind, randomised controlled trial.

机构信息

Department of Anaesthesiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.

Department of Ophthalmology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.

出版信息

Anaesthesia. 2015 Dec;70(12):1390-4. doi: 10.1111/anae.13212. Epub 2015 Sep 8.

Abstract

Surgical drapes used during eye surgery are impermeable to air and hence risk trapping air underneath them. We investigated the effect of a forced-air warming blanket on carbon dioxide accumulation under the drapes in patients undergoing eye surgery under local anaesthesia without sedation. Forty patients of ASA physical status 1 and 2 were randomly assigned to either the forced-air warmer (n = 20) or a control heated overblanket (n = 20). All patients were given 1 l.min(-1) oxygen. We measured transcutaneous and end-tidal carbon dioxide partial pressures, heart rate, arterial pressure, respiratory rate, temperature and oxygen saturation before and after draping, then every 5 min thereafter for 30 min. The mean (SD) transcutaneous carbon dioxide partial pressure in the forced-air warming group stayed constant after draping at 5.7 (0.2) kPa but rose to a maximum of 6.4 (0.4) kPa in the heated overblanket group (p = 0.0001 for the difference at time points 15 min and later). We conclude that forced-air warming reduces carbon dioxide accumulation under the drapes in patients undergoing eye surgery under local anaesthesia.

摘要

手术中用于眼部手术的手术巾是不透空气的,因此有在其下方截留空气的风险。我们研究了在局部麻醉下不镇静的眼部手术患者中,使用强制空气加热毯对手术巾下二氧化碳积聚的影响。40 名 ASA 身体状况 1 和 2 的患者被随机分配到强制空气加热组(n = 20)或加热覆盖物组(n = 20)。所有患者均给予 1 l.min(-1)氧气。我们在覆盖前后以及之后每 5 分钟测量一次经皮和呼气末二氧化碳分压、心率、动脉压、呼吸率、温度和氧饱和度。在强制空气加热组中,覆盖后经皮二氧化碳分压保持在 5.7(0.2)kPa 的平均值(SD)不变,但在加热覆盖物组中升高至最高 6.4(0.4)kPa(在 15 分钟及以后的时间点的差异,p = 0.0001)。我们得出结论,在局部麻醉下进行眼部手术的患者中,强制空气加热可减少手术巾下的二氧化碳积聚。

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