Department of Anaesthesia, Brighton & Sussex University Hospitals NHS Trust, Brighton, UK.
Department of Anaesthesia, Brighton & Sussex University Hospitals NHS Trust, Brighton, UK.
Int J Obstet Anesth. 2021 May;46:102963. doi: 10.1016/j.ijoa.2021.102963. Epub 2021 Jan 28.
Temperature regulation in women undergoing emergency caesarean section is a complex topic about which there is a paucity of evidence-based recommendations. The adverse effects of inadvertent peri-operative hypothermia are well described. Hyperthermia is also associated with adverse neonatal outcomes, an increased risk of obstetric intervention and increased treatment for suspected sepsis. We conducted a multi-centre observational cohort study to identify the prevalence of hypothermia and hyperthermia during emergency caesarean section. S: Participants undergoing emergency caesarean section were recruited across 14 sites in the UK. The primary end point was maternal temperature in the recovery room. Temperature was measured using a zero heat-flux temperature monitoring device.
Two hundred and sixty-five participants were recruited over a 12-month period. The prevalence of hypothermia (<36.0°C) was 10.7% and the prevalence of hyperthermia (>37.5°C) was 14.7% on admission to recovery. The prevalence of hypothermia, normothermia, and hyperthermia differed among type of anaesthesia: 71.4% of the hypothermic group had received a spinal anaesthetic whereas 76.9% of the hyperthermic group had received epidural top-up anaesthesia. There was a significant decrease in maternal temperature between the time of delivery and admission to the recovery room of 0.20°C (95% CI 0.15 to 0.25, P<0.001).
Both hypothermia and hyperthermia are prevalent findings in mothers who undergo emergency caesarean section. Therefore, accurate temperature measurement is essential to ensure that an appropriate intra-operative temperature management strategy is employed.
在接受紧急剖宫产的女性中，体温调节是一个复杂的问题，目前缺乏循证推荐。无意中发生围手术期低体温的不良影响已有详细描述。体温过高也与新生儿不良结局、产科干预风险增加以及疑似败血症的治疗增加有关。我们进行了一项多中心观察性队列研究，以确定紧急剖宫产期间低体温和体温过高的发生率。
在英国的 14 个地点招募了接受紧急剖宫产的参与者。主要终点是恢复室的产妇体温。使用零热通量温度监测设备测量温度。
在 12 个月的时间内招募了 265 名参与者。入院时体温过低（<36.0°C）的发生率为 10.7%，体温过高（>37.5°C）的发生率为 14.7%。麻醉类型之间的体温过低、正常体温和体温过高的发生率不同：71.4%的体温过低组接受了脊髓麻醉，而 76.9%的体温过高组接受了硬膜外追加麻醉。从分娩到进入恢复室，产妇体温显著下降 0.20°C（95%CI 0.15 至 0.25，P<0.001）。
在接受紧急剖宫产的母亲中，体温过低和体温过高都是常见的发现。因此，准确测量体温对于确保采用适当的术中体温管理策略至关重要。
