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主动升温对局部麻醉下玻璃体视网膜手术患者围手术期意外低体温的影响。

The effects of active warming on perioperative inadvertent hypothermia in patients undergoing vitreoretinal surgery under local anesthesia.

机构信息

Department of Anesthesiology and Reanimation, Kahramanmaras Sutcu Imam University, Faculty of Medicine, Kahramanmaras, Turkey.

Department of Ophthalmology, Kahramanmaras Sutcu Imam University, Faculty of Medicine, Kahramanmaras, Turkey.

出版信息

Indian J Ophthalmol. 2021 Feb;69(2):308-313. doi: 10.4103/ijo.IJO_227_20.

Abstract

PURPOSE

Perioperative inadvertent hypothermia (PIH) is the decrease in core temperature below 36°C. We aimed to assess whether PIH develops in patients operated under local anesthesia (ULA) for vitreoretinal surgery in the operating room and investigate active warming efficacy.

METHODS

Seventy-two patients were divided into two groups: Group 1 contained unwarmed patients (n = 36), and Group 2, warmed patients (n = 36). The core temperatures, heart rate (HR), and mean arterial pressure (MAP) of the patients were measured at the beginning of surgery, after 20 min, 40 min, 1 h, at the end of the operation, and during the postoperative period.

RESULTS

PIH incidence was 44.6% in Group 1, whereas no hypothermia was observed in Group 2. Patient temperatures at 20 min (P = 0.001), 40 min (P < 0.001), 1 h (P < 0.001), the end of the operation (P < 0.001), and the postoperative period (P < 0.001) were significantly higher in Group 2 than in Group 1. Patient HRs at the end of the operation and during the postoperative period were significantly lower in Group 2 (P = 0.005) than in Group 1 (P < 0.001). The intraoperative 40 (P = 0.044) and 60 (P < 0.001) minutes, end of operation (P < 0.001), and postoperative MAP (P < 0.001) values of Group 1 were significantly higher than those of Group 2.

CONCLUSION

PIH may develop in patients operated ULA, especially with a low ambient temperature. Actively warming may help prevent the harmful effects of PIH.

摘要

目的

围手术期意外低体温(PIH)是指核心体温降至 36°C 以下。我们旨在评估在手术室接受局部麻醉(ULA)行玻璃体视网膜手术的患者是否会发生 PIH,并研究主动升温的效果。

方法

72 名患者分为两组:未加热组(n = 36)和加热组(n = 36)。在手术开始时、20 分钟后、40 分钟后、1 小时后、手术结束时和术后期间测量患者的核心体温、心率(HR)和平均动脉压(MAP)。

结果

组 1 的 PIH 发生率为 44.6%,而组 2 未观察到低体温。组 2 的患者在 20 分钟(P = 0.001)、40 分钟(P < 0.001)、1 小时(P < 0.001)、手术结束时(P < 0.001)和术后期间(P < 0.001)的体温明显高于组 1。组 2 的患者在手术结束时和术后期间的 HR 明显低于组 1(P = 0.005)。组 1 的术中 40 分钟(P = 0.044)和 60 分钟(P < 0.001)、手术结束时(P < 0.001)和术后 MAP(P < 0.001)值明显高于组 2。

结论

在接受 ULA 手术的患者中,尤其是在环境温度较低的情况下,可能会发生 PIH。主动升温可能有助于预防 PIH 的有害影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18c0/7933865/3ea708d115ed/IJO-69-308-g001.jpg

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