Jin Lin, Han Xiaodan, Yu Ying, Xu Liying, Wang Huilin, Guo Kefang
Department of Anesthesia, Zhongshan Hospital, Fudan University, Shanghai, China.
Ann Transl Med. 2020 Oct;8(19):1220. doi: 10.21037/atm-19-4571.
About 50% patients who underwent off-pump coronary artery bypass grafting (OPCAB) experienced perioperative hypothermia. Pre-warming and intraoperative infusion of amino acid injection are the most popular perioperative insulation measures in recent years, but neither of them can completely prevent intraoperative hypothermia. The objective is to investigate the effect of preoperative warming and/or intraoperative infusion of amino acid injection on body temperature in patients undergoing OPCAB.
A prospective, double blind, randomized controlled, single-center study. Seventy-two patients were randomly divided into 4 groups: control group, pre-warming group, amino-acid group and multi-mode group. Pre-warming and multi-mode group were pre-heated with warming blankets and forced-air warming system before induction. After that, amino-acid and multi-mode group were infused with 18-amino acid solution. The perioperative temperature and complications were monitored.
The temperature of control and amino-acid group decreased significantly, but amino-acid group recovered to preoperative level faster. The temperature of pre-warming group was stable, and that in multi-mode group increased at 60 min after the start of surgery. There was a significant difference in temperature at each time, and no difference in the incidence of complications between the groups.
Preoperative warming and/or intraoperative infusion of amino acid injection can effectively reduce hypothermia in OPCAB surgery. Pre-warming before anesthesia is more effective, and the combination of the two methods has the best effect.
约50%接受非体外循环冠状动脉搭桥术（OPCAB）的患者在围手术期出现体温过低。术前预热和术中输注氨基酸注射液是近年来最常用的围手术期保温措施，但两者均不能完全预防术中体温过低。目的是探讨术前预热和/或术中输注氨基酸注射液对接受OPCAB手术患者体温的影响。
一项前瞻性、双盲、随机对照、单中心研究。72例患者随机分为4组：对照组、预热组、氨基酸组和多模式组。预热组和多模式组在诱导前用温毯和强制空气加热系统进行预热。之后，氨基酸组和多模式组输注18种氨基酸溶液。监测围手术期体温和并发症。
对照组和氨基酸组体温显著下降，但氨基酸组恢复到术前水平更快。预热组体温稳定，多模式组在手术开始后60分钟体温升高。各时间点体温有显著差异，各组并发症发生率无差异。
术前预热和/或术中输注氨基酸注射液可有效降低OPCAB手术中的体温过低。麻醉前预热更有效，两种方法联合使用效果最佳。
