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体温调节与麻醉

Body temperature regulation and anesthesia.

作者信息

Lenhardt Rainer

机构信息

Department of Anesthesiology, University of Louisville, Louisville, KY, United States.

出版信息

Handb Clin Neurol. 2018;157:635-644. doi: 10.1016/B978-0-444-64074-1.00037-9.

Abstract

General anesthesia is the induction and maintenance of a state of unconsciousness with the absence of pain sensation. General anesthesia is accomplished by the administration of a combination of inhaled anesthetic gases and intravenous drugs. These medications eliminate behavioral thermoregulatory compensations, leaving only autonomic defenses to offset environmental perturbations. Anesthetics inhibit thermoregulatory control in a dose-dependent fashion over the entire clinical range. Impairment of thermoregulatory control is observed by a change in thermoregulatory thresholds with the vasoconstriction threshold being affected about three times as much as the sweating threshold. Consequently, the zone between sweating and vasoconstriction thresholds, called interthreshold range, is widened dose-dependently. Impairment of thermoregulation, triggered by general anesthesia, typically causes inadvertent hypothermia. In febrile patients, general anesthesia reduces the magnitude of perioperative fever.

摘要

全身麻醉是诱导并维持一种无意识且无疼痛感觉的状态。全身麻醉通过吸入麻醉气体和静脉药物联合给药来实现。这些药物消除了行为性体温调节补偿,仅留下自主防御机制来抵消环境干扰。麻醉药在整个临床剂量范围内以剂量依赖的方式抑制体温调节控制。通过体温调节阈值的变化可观察到体温调节控制受损,其中血管收缩阈值受到的影响约为出汗阈值的三倍。因此,出汗阈值和血管收缩阈值之间的区域,即阈间范围,会随剂量增加而变宽。全身麻醉引发的体温调节受损通常会导致意外体温过低。在发热患者中,全身麻醉会降低围手术期发热的程度。

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