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腹腔镜手术中的短期预升温。一项评估当前临床实践的非随机临床试验。

Short-Periods of Pre-Warming in Laparoscopic Surgery. A Non-Randomized Clinical Trial Evaluating Current Clinical Practice.

作者信息

Becerra Ángel, Valencia Lucía, Villar Jesús, Rodríguez-Pérez Aurelio

机构信息

Department of Anesthesiology, Hospital Universitario de Gran Canaria Doctor Negrín, 35010 Las Palmas de Gran Canaria, Spain.

Department of Medical and Surgical Sciences, Universidad de Las Palmas de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain.

出版信息

J Clin Med. 2021 Mar 3;10(5):1047. doi: 10.3390/jcm10051047.

Abstract

Pre-warming prevents perioperative hypothermia. We evaluated the current clinical practice of pre-warming and its effects on temperature drop and postoperative complications; Methods: This prospective, observational pilot study examines clinical practice in a tertiary hospital on 99 patients undergoing laparoscopic urological surgery. Pre-warming was performed in the pre-anesthesia room. Patients were classified into three groups: P 0 (non-prewarmed), P 5-15 (pre-warming 5-15 min) and P > 15 (pre-warming 15-30 min). Tympanic temperature was recorded in the pre-anesthesia room, prior to anesthesia induction, and in the PACU. Esophageal temperature was recorded intraoperatively. The occurrence of shivering, pain intensity, length of stay in PACU, and postoperative complications during hospital stay were also recorded; Results: After pre-warming, between-group difference in body temperature was higher in P > 15 than in P 0 (0.4 °C, 95% CI 0.14-0.69, = 0.004). Between P 5-15 and P 0 difference was 0.2 °C (95% CI 0.04-0.55, = 0.093). Temperature at the end of surgery was higher in pre-warmed groups [mean between-group difference 0.5 °C (95% CI 0.13-0.81, = 0.007) for P 5-15; 0.9 °C (95% CI 0.55-1.19, < 0.001) for P > 15]. Pain and shivering was less common in pre-warmed groups. Postoperative transfusions and surgical site infections were lower in P > 15; Conclusion: Short-term pre-warming prior to laparoscopic urological surgery decreased temperature perioperative drop and postoperative complications.

摘要

术前预热可预防围手术期体温过低。我们评估了当前术前预热的临床实践及其对体温下降和术后并发症的影响;方法:这项前瞻性观察性试点研究考察了一家三级医院中99例接受腹腔镜泌尿外科手术患者的临床实践。在麻醉前室进行术前预热。患者被分为三组:P 0(未预热)、P 5 - 15(预热5 - 15分钟)和P > 15(预热15 - 30分钟)。在麻醉前室、麻醉诱导前以及麻醉后监护病房(PACU)记录鼓膜温度。术中记录食管温度。还记录了寒战的发生情况、疼痛强度、在PACU的停留时间以及住院期间的术后并发症;结果:预热后,P > 15组体温的组间差异高于P 0组(0.4℃,95%置信区间0.14 - 0.69,P = 0.004)。P 5 - 15组与P 0组的差异为0.2℃(95%置信区间0.04 - 0.55,P = 0.093)。预热组手术结束时的体温更高[P 5 - 15组的组间平均差异为0.5℃(95%置信区间0.13 - 0.81,P = 0.007);P > 15组为0.9℃(95%置信区间0.55 - 1.19,P < 0.001)]。预热组疼痛和寒战较少见。P > 15组术后输血和手术部位感染较少;结论:腹腔镜泌尿外科手术前的短期预热可减少围手术期体温下降和术后并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9b0/7959470/a9da57205442/jcm-10-01047-g001.jpg

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