Jo Youn Yi, Chang Young Jin, Kim Yong Beom, Lee Sehwan, Kwak Hyun Jeong
Department of Anesthesiology and Pain Medicine, Gachon University, Gil Medical Center, Incheon, South Korea.
Urol J. 2015 Nov 14;12(5):2366-70.
Elderly patients under spinal anesthesia are vulnerable to hypothermia, leading to increased morbidity. The aim of this study was to investigate the effects of preoperative forced-air warming on perioperative hypothermia and shivering in elderly patients undergoing transurethral resection of the prostate (TURP) under spinal anesthesia.
Patients (> 65-year-old) scheduled for TURP under spinal anesthesia were randomly assigned to receive preoperative forced-air skin warming for 20 min (the pre-warmed group, n = 25) or not (control group, n = 25). Core temperatures were measured at 15-min intervals after spinal anesthesia, and intra- and post-operative shivering were also assessed.
Incidences of intraoperative hypothermia (< 36 ºC) in the pre-warmed and control groups were not significantly different (10/25 [40%] vs. 15/24 [62.5%], P = .259). However, severities of hypothermia were significantly different (P = .019). No patient in the pre-warmed group showed moderate or profound hypothermia, whereas of patients in control group 21% and 13% did so, respectively.
This study demonstrated that a brief period of preoperative forced-air warming did not completely prevent intraoperative hypothermia or shivering, but it could significantly reduce its severity in elderly male patients under spinal anesthesia.
接受脊髓麻醉的老年患者易发生体温过低,导致发病率增加。本研究的目的是探讨术前强制空气加温对脊髓麻醉下接受经尿道前列腺切除术(TURP)的老年患者围手术期体温过低和寒战的影响。
计划在脊髓麻醉下进行TURP的患者(年龄>65岁)被随机分配接受术前20分钟的强制空气皮肤加温(预加温组,n = 25)或不接受(对照组,n = 25)。脊髓麻醉后每隔15分钟测量一次核心体温,并评估术中及术后的寒战情况。
预加温组和对照组术中体温过低(<36℃)的发生率无显著差异(10/25 [40%] 对 15/24 [62.5%],P = 0.259)。然而,体温过低的严重程度有显著差异(P = 0.019)。预加温组没有患者出现中度或重度体温过低,而对照组分别有21%和13%的患者出现中度或重度体温过低。
本研究表明,术前短时间的强制空气加温并不能完全预防术中体温过低或寒战,但它可以显著降低脊髓麻醉下老年男性患者体温过低的严重程度。