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体重指数对围手术期体温调节的影响。

The effect of body mass index on perioperative thermoregulation.

作者信息

Özer Ayşe Belin, Yildiz Altun Aysun, Erhan Ömer Lütfi, Çatak Tuba, Karatepe Ümit, Demirel İsmail, Çağlar Toprak Gonca

机构信息

Department of Anesthesiology and Intensive Care, Firat University Medical School, Elaziğ.

Department of Anesthesiology and Intensive Care Clinic, Bingol State Hospital, Bingöl.

出版信息

Ther Clin Risk Manag. 2016 Nov 18;12:1717-1720. doi: 10.2147/TCRM.S122700. eCollection 2016.

Abstract

PURPOSE

We evaluated the effects of body mass index (BMI) on thermoregulation in obese patients scheduled to undergo laparoscopic abdominal surgery.

METHODS

Sixty patients scheduled to undergo laparoscopic abdominal surgery with no pre-medication were included in the study. The patients were classified into 4 groups according to BMI <24.9, 25-39.9, 40-49.9, and >50. Anesthesia was provided with routine techniques. Tympanic and peripheral temperatures were recorded every 5 minutes starting with the induction of anesthesia. The mean skin temperature (MST), mean body temperature (MBT), vasoconstriction time, and vasoconstriction threshold that triggers core warming were calculated with the following formulas: MST = 0.3 ( + ) + 0.2 ( + ). MBT was calculated using the equation 0.64+0.36, and vasoconstriction was determined by calculating -.

RESULTS

There was no significant difference between the groups in terms of age, gender, duration of operation, and room temperature. Compared to those with BMI <24.9, the tympanic temperature was significantly higher in those with BMI =25-39.9 in the 10th, 15th, 20th, and 50th minutes. In addition, BMI =40-49.9 in the 5th, 10th, 15th, 20th, 25th, 30th, 40th, 45th, 50th, and 55th minutes and BMI >50 in the 5th, 10th, 15th, 20th, 25th, 30th, 50th, and 55th minutes were less than those with BMI <24.9 (<0.05). There was no significant difference in terms of MST and MBT. Vasoconstriction occurred later, and that vasoconstriction threshold was significantly higher in patients with higher BMIs.

CONCLUSION

Under anesthesia, the core temperature was protected more easily in obese patients as compared to nonobese patients. Therefore, obesity decreases the negative effects of anesthesia on thermoregulation.

摘要

目的

我们评估了体重指数(BMI)对计划接受腹腔镜腹部手术的肥胖患者体温调节的影响。

方法

本研究纳入了60例计划接受腹腔镜腹部手术且未进行术前用药的患者。根据BMI将患者分为4组:BMI<24.9、25 - 39.9、40 - 49.9和>50。采用常规技术进行麻醉。从麻醉诱导开始,每5分钟记录一次鼓膜温度和外周温度。用以下公式计算平均皮肤温度(MST)、平均体温(MBT)、血管收缩时间和触发核心体温升高的血管收缩阈值:MST = 0.3(+)+ 0.2(+)。MBT使用方程0.64 + 0.36计算,血管收缩通过计算 - 来确定。

结果

各组在年龄、性别、手术持续时间和室温方面无显著差异。与BMI<24.9的患者相比,BMI = 25 - 39.9的患者在第10、15、20和50分钟时鼓膜温度显著更高。此外,BMI = 40 - 49.9的患者在第5、10、15、20、25、30、40、45、50和55分钟以及BMI>50的患者在第5、10、15、20、25、30、50和55分钟时的温度低于BMI<24.9的患者(<0.05)。MST和MBT方面无显著差异。血管收缩发生较晚,且BMI较高的患者血管收缩阈值显著更高。

结论

与非肥胖患者相比,肥胖患者在麻醉下核心体温更容易得到保护。因此,肥胖可降低麻醉对体温调节的负面影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d5cf/5125719/f255563a4d78/tcrm-12-1717Fig1.jpg

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