Im Ui Jae, Lee Dong Jun, Kim Mun Cheol, Lee Jeong Seok, Lee Sang Jun
Department of Anesthesiology and Pain Medicine, Inje University, Seoul Paik Hospital, Seoul, Korea.
Korean J Anesthesiol. 2009 Dec;57(6):704-708. doi: 10.4097/kjae.2009.57.6.704.
Hypothermia following the induction of anesthesia is caused by core to peripheral redistribution of body heat. It has been reported that propofol causes more severe hypothermia than sevoflurane by inhibiting thermoregulatory vasoconstriction during surgical procedures. Therefore, we evaluated the induction and maintenance of anesthesia with intravenous propofol to determine if it causes more core hypothermia than inhaled sevoflurane.
Forty-five patients who underwent hysterectomy were divided into two groups randomly, a propofol-remifentanil (PR) anesthesia group and a sevoflurane-remifentanil (SR) anesthesia group. Each group was subjected to anesthetic induction with either 1.5 mg/kg propofol or inhalation of 5% sevoflurane, respectively. Anesthesia in the former group was maintained with propofol while it was maintained with sevoflurane in the latter group. Specifically, 6-10 mg/kg/hr propofol, 3 L/min medical air, 2 L/min O2, and 0.25 mg/kg/hr remifentanil were used in the PR group for maintenance, while 1.5 vol% sevoflurane, 3 L/min medical air, 2 L/min O2 and 0.25 mg/kg/hr remifentanil were used for maintenance in the SR group. We measured the core temperature 8 times, prior to induction and 10, 20, 30, 45, 60, 75 and 90 minutes after induction.
Core temperatures decreased in both the PR and SR group during surgical operation, but there was no significant difference between the two groups.
Anesthesia induced and maintained by propofol did not cause a greater degree of hypothermia than sevoflurane.
麻醉诱导后体温过低是由体热从核心向外周重新分布引起的。据报道,在手术过程中,丙泊酚通过抑制体温调节性血管收缩,导致的体温过低比七氟醚更严重。因此,我们评估了静脉注射丙泊酚诱导和维持麻醉的情况,以确定其是否比吸入七氟醚导致更严重的核心体温过低。
45例行子宫切除术的患者被随机分为两组,即丙泊酚-瑞芬太尼(PR)麻醉组和七氟醚-瑞芬太尼(SR)麻醉组。每组分别用1.5mg/kg丙泊酚或吸入5%七氟醚进行麻醉诱导。前一组用丙泊酚维持麻醉,而后一组用七氟醚维持麻醉。具体而言,PR组维持麻醉时使用6-10mg/kg/小时丙泊酚、3L/分钟医用空气、2L/分钟氧气和0.25mg/kg/小时瑞芬太尼,而SR组维持麻醉时使用1.5vol%七氟醚、3L/分钟医用空气、2L/分钟氧气和0.25mg/kg/小时瑞芬太尼。我们在诱导前以及诱导后10、20、30、45、60、75和90分钟测量了8次核心体温。
手术过程中PR组和SR组的核心体温均下降,但两组之间无显著差异。
丙泊酚诱导和维持的麻醉不会比七氟醚导致更严重的体温过低。