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全身麻醉下截石位内窥镜手术中,下体毯的加热效果优于上身毯:一项随机试验。

Underbody blankets have a higher heating effect than overbody blankets in lithotomy position endoscopic surgery under general anesthesia: a randomized trial.

机构信息

Department of Operation Center, National Hospital Organization Nagasaki Medical Center, Kubara 2-1001-1, Omura, Nagasaki, 856-8562, Japan.

Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, 852-8523, Japan.

出版信息

Surg Endosc. 2022 Jan;36(1):670-678. doi: 10.1007/s00464-021-08335-y. Epub 2021 Jan 29.

DOI:10.1007/s00464-021-08335-y
PMID:33512629
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7845577/
Abstract

BACKGROUND

Surgery under general anesthesia results in temperature decrease due to the effect of anesthetics and peripheral vasodilation on thermoregulatory centers. Perioperative temperature control is therefore an issue of high importance. In this study, we aimed to compare the warming effect of underbody and overbody blankets in patients undergoing surgery in the lithotomy position under general anesthesia.

METHODS

From September 2018 to October 2019, 99 patients undergoing surgery for colorectal cancer in the lithotomy position were included in this randomized controlled trial and assigned to the intervention group (underbody blanket) or control group (overbody blanket).

RESULTS

The central temperature was significantly higher in the underbody blanket group than in the overbody blanket group at 90 min after the beginning of the surgery (p = 0.02); also in this group, the peripheral temperature was significantly higher 60 min after the beginning of the surgery (p = 0.02). Regarding postoperative factors, the underbody blanket group had a significantly lower frequency of postoperative shivering (p < 0.01) and a significantly shorter postoperative hospital stay (p = 0.04) than the overbody blanket group.

CONCLUSIONS

We recommend the use of underbody blankets for intraoperative temperature control in patients undergoing surgery in the lithotomy position under general anesthesia. Underbody blankets showed improved rise and maintenance of central and peripheral temperature, decreased the incidence of postoperative shivering, and shortened the postoperative length of hospital stay.

摘要

背景

全身麻醉下的手术会因麻醉药物和外周血管扩张对体温调节中枢的影响而导致体温下降。因此,围手术期体温控制是一个非常重要的问题。在这项研究中,我们旨在比较在全身麻醉下截石位手术患者使用下身和上身毯子的升温效果。

方法

2018 年 9 月至 2019 年 10 月,我们将 99 例在截石位接受大肠癌手术的患者纳入这项随机对照试验,并将其分配到干预组(下身毯子)或对照组(上身毯子)。

结果

与上身毯子组相比,下身毯子组在手术开始后 90 分钟时中心温度显著升高(p=0.02);在手术开始后 60 分钟时,下身毯子组的外周温度也显著升高(p=0.02)。在术后因素方面,下身毯子组术后寒战的发生频率明显较低(p<0.01),术后住院时间明显缩短(p=0.04)。

结论

我们建议在全身麻醉下截石位手术的患者中使用下身毯子来控制术中体温。下身毯子可提高中心和外周温度的升高和维持,降低术后寒战的发生率,并缩短术后住院时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f18d/7845577/87e9ef410b7f/464_2021_8335_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f18d/7845577/e6f0d0a1c3cf/464_2021_8335_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f18d/7845577/a8b7cebc0c9d/464_2021_8335_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f18d/7845577/87e9ef410b7f/464_2021_8335_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f18d/7845577/e6f0d0a1c3cf/464_2021_8335_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f18d/7845577/a8b7cebc0c9d/464_2021_8335_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f18d/7845577/87e9ef410b7f/464_2021_8335_Fig3_HTML.jpg

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