Department of Anaesthesiology and Pain Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea.
Department of Anaesthesiology and Pain Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea.
Br J Anaesth. 2018 Mar;120(3):555-562. doi: 10.1016/j.bja.2017.11.091. Epub 2017 Dec 5.
In the supine position, forced-air warming is more effective on the lower body than on the upper body to prevent intraoperative hypothermia. However, it is unknown in the lateral decubitus position. We thus compared forced-air warming on the upper and lower bodies in the lateral position.
Patients (n=123) were randomised to receive forced-air warming on the upper body or lower body during thoracoscopic surgery in the lateral position. We measured the nasopharyngeal temperature at 0, 30, 60, 90, and 120 min after lateral positioning during surgery and the infrared tympanic membrane temperature at 0, 30, 60, 90, and 120 min after surgery. Patients received both upper and lower body warming at a temperature of <35.5°C. The primary outcome was the incidence of intraoperative hypothermia with a temperature of <36.0°C.
Intraoperative hypothermia was less frequent with the upper body warming than with the lower body warming {21/62 vs 35/61, risk ratio [95% confidence interval (CI)] 0.6 (0.4-0.9), P=0.011}. The intraoperative temperature was higher with the upper body warming than with the lower body warming at 30 (P=0.002), 60 (P<0.001), and 90 (P<0.001) min after lateral positioning, and the postoperative temperature was higher at 0 (P<0.001) and 30 (P=0.001) min after surgery. Fewer patients received both upper and lower body warming in the upper body warming group than in the lower body warming group during surgery (1 vs 7, P=0.032).
Forced-air warming was more effective on the upper body than on the lower body to prevent hypothermia during thoracoscopic surgery in the lateral decubitus position.
NCT02993666.
在仰卧位时，与上半身相比，空气对流加热在下半身更有效，可以预防术中低体温。但在侧卧位时，其效果尚不清楚。因此，我们比较了侧卧位时上半身和下半身的空气对流加热效果。
123 例患者随机在侧卧位胸腔镜手术中接受上半身或下半身空气对流加热。在手术中侧卧位 0、30、60、90 和 120 分钟时测量鼻咽温度，手术后 0、30、60、90 和 120 分钟时测量鼓膜温度。当体温<35.5°C 时，患者接受上半身和下半身的保暖。主要结局是术中体温<36.0°C 的低体温发生率。
与下半身保暖相比，上半身保暖时术中低体温的发生率较低[21/62 比 35/61，风险比（95%置信区间）0.6（0.4-0.9），P=0.011]。与下半身保暖相比，上半身保暖时 30（P=0.002）、60（P<0.001）和 90（P<0.001）分钟时的术中体温更高，术后 0（P<0.001）和 30（P=0.001）分钟时的体温更高。手术中，上半身保暖组接受上半身和下半身保暖的患者少于下半身保暖组（1 比 7，P=0.032）。
在侧卧位胸腔镜手术中，与下半身相比，空气对流加热对上半身更有效，可以预防低体温。
NCT02993666。
