Suzuki Kengo, Wanibuchi Masahiko, Minamida Yoshihiro, Akiyama Yukinori, Mikami Takeshi, Fujishige Masahito, Yamamura Akinori, Nakagawa Toshio, Mikuni Nobuhiro
Department of Neurosurgery, Sapporo Medical University School of Medicine, South 1, West 16, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan.
Department of Neurosurgery, Shinsapporo Neurosurgical Hospital, Sapporo, Hokkaido, Japan.
Acta Neurochir (Wien). 2018 Apr;160(4):721-725. doi: 10.1007/s00701-017-3445-0. Epub 2018 Jan 4.
Ultrasonic bone curettes have been used as with high-speed drills. However, the amount of heat generated by the ultrasonic bone curette is not well known. This study quantitatively assessed the heat generated by an ultrasonic bone curette and compared it to that by a high-speed drill.
The thermal change in a swine skull during bone curetting using an ultrasonic device and a high-speed drill were assessed. The investigation focused on the type of surgical manipulation (brush-like strokes vs. pushing motion) and irrigation (room temperature vs. cold water; low-volume irrigation vs. high-volume irrigation).
The thermal elevation during drill use was suppressed when using brush-like strokes compared to pushing motion (brush-like strokes, 44.7 °C; pushing motion, 69.2 °C; p < 0.01). Cold-water irrigation while drilling had a small effect compared to room temperature (RT) water (RT, 44.7 °C; cold, 35.2 °C; p = 0.12). The temperature generated by the curette was higher than that generated by the drill (curette, 72.5 °C; drill, 44.7 °C; p < 0.01). High-volume irrigation was required to reduce the heat generated by the curette (no irrigation, 88.6 °C; low-volume, 72.5 °C; high-volume, 60.5 °C; p < 0.01).
The ultrasonic bone curate generated more heat than the high-speed drill. During surgical manipulation, the use of brush-like strokes by both the high-speed drill and the ultrasonic bone curette is necessary to avoid excess thermal elevation. Irrigation with RT water is sufficient to avoid heat generation. High-volume irrigation is required to reduce the heat generated by the curette.
超声骨刮匙已与高速钻一同使用。然而,超声骨刮匙产生的热量尚不为人所知。本研究定量评估了超声骨刮匙产生的热量,并将其与高速钻产生的热量进行比较。
评估了使用超声设备和高速钻刮除猪颅骨时的热变化。研究重点在于手术操作类型(刷状划动与推压动作)和冲洗(室温与冷水;低容量冲洗与高容量冲洗)。
与推压动作相比,使用高速钻时采用刷状划动可抑制热升高(刷状划动,44.7℃;推压动作,69.2℃;p<0.01)。与室温(RT)水相比,钻孔时用冷水冲洗的效果较小(RT,44.7℃;冷水,35.2℃;p = 0.12)。刮匙产生的温度高于钻产生的温度(刮匙,72.5℃;钻,44.7℃;p<0.01)。需要高容量冲洗以减少刮匙产生的热量(无冲洗,88.6℃;低容量,72.5℃;高容量,60.5℃;p<0.01)。
超声骨刮匙产生的热量比高速钻更多。在手术操作过程中,高速钻和超声骨刮匙都有必要采用刷状划动以避免过度热升高。用RT水冲洗足以避免产热。需要高容量冲洗以减少刮匙产生的热量。