主动空气加热在麻醉诱导期间预防术中保温患者术中意外低体温的疗效:与被动保温的比较,一项随机对照试验。
Efficacy of active forced air warming during induction of anesthesia to prevent inadvertent perioperative hypothermia in intraoperative warming patients: Comparison with passive warming, a randomized controlled trial.
机构信息
Department of Anesthesiology and Pain Medicine.
Department of Cardiovascular and thoracic surgery, Soonchunhyang University Hospital Seoul, Seoul, Republic of Korea.
出版信息
Medicine (Baltimore). 2021 Mar 26;100(12):e25235. doi: 10.1097/MD.0000000000025235.
BACKGROUND
This study aimed to evaluate the efficacy of peri-induction forced air warming to prevent inadvertent perioperative hypothermia, defined as a reduction in body temperature to <36.0°C during the perioperative period, in intraoperatively warmed patients receiving major surgery lasting >120 minutes.
METHODS
In total, 130 patients scheduled for elective surgery under general anesthesia lasting >120 minutes were divided into 2 groups: peri-induction warming (n = 65) and control (n = 65). Patients in the peri-induction warming group were warmed during the anesthetic induction period using a forced-air warmer set at 47°C, whereas patients in the control group were covered passively with a cotton blanket. All patients were warmed with a forced-air warmer during surgery. Body temperature was measured using a tympanic membrane thermometer in the pre- and postoperative periods and using a nasopharyngeal temperature probe during surgery. Patients were evaluated for shivering scale score, thermal comfort scale score, and satisfaction score in the post-anesthesia care unit.
RESULTS
The incidence rates of intraoperative and postoperative hypothermia were lower in the peri-induction warming group than in the control group (19.0% vs 57.1%, P < .001; 3.3% vs 16.9%, P = .013, respectively). Body temperature was higher in the peri-induction warming group (P < .001). However, intraoperative blood loss, as well as postoperative thermal comfort scale score, shivering scale score, and patient satisfaction score, were similar between groups. Post-anesthesia care unit duration was also similar between groups.
CONCLUSIONS
Peri-induction active forced air warming is an effective, simple, and convenient method to prevent inadvertent perioperative hypothermia in intraoperatively warmed patients undergoing major surgery lasting >120 minutes.
背景
本研究旨在评估诱导期强制空气加热预防术中意外低体温的疗效,术中意外低体温定义为围手术期体温降至<36.0°C。本研究纳入了 130 例行全身麻醉且手术时间>120 分钟的择期手术患者,分为诱导期加热组(n=65)和对照组(n=65)。诱导期加热组患者在麻醉诱导期使用 47°C 的空气加热器进行加热,而对照组患者则被动覆盖棉毯。所有患者在手术期间均使用空气加热器进行加热。在术前和术后使用鼓膜温度计测量体温,在手术期间使用鼻咽温度探头测量体温。在麻醉后恢复室评估患者的寒战评分、热舒适度评分和满意度评分。
结果
与对照组相比,诱导期加热组术中及术后低体温的发生率较低(19.0% vs 57.1%,P<0.001;3.3% vs 16.9%,P=0.013),诱导期加热组患者的体温较高(P<0.001)。然而,两组患者的术中失血量、术后热舒适度评分、寒战评分和患者满意度评分相似。两组患者在麻醉后恢复室的停留时间也相似。
结论
对于行>120 分钟全身麻醉手术且术中进行了体温加热的患者,诱导期主动强制空气加热是一种有效、简单且方便的预防术中意外低体温的方法。