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右美托咪定麻醉相关体温变化评估:初步回顾性观察研究。

Evaluation of dexmedetomidine anesthesia-related temperature changes: preliminary retrospective observational study.

机构信息

Universidade Federal de São Paulo, Escola Paulista de Medicina, Disciplina de Anestesiologia, Dor e Terapia Intensiva, São Paulo, SP, Brazil.

Universidade Federal de São Paulo, Escola Paulista de Medicina, Disciplina de Anestesiologia, Dor e Terapia Intensiva, São Paulo, SP, Brazil.

出版信息

Braz J Anesthesiol. 2022 Mar-Apr;72(2):232-240. doi: 10.1016/j.bjane.2021.02.062. Epub 2021 Jun 29.

Abstract

INTRODUCTION AND OBJECTIVE

Dexmedetomidine is a potent adrenergic alpha-2 agonist, and analgesic, sedative, anxiolytic and sympatholytic. Given there have been reports of dexmedetomidine associated temperature changes, in which these events have been associated with complications, our objective was to describe both temperature increase and decrease, during the intra and postoperative period (initial 24 hours), and factors associated, in patients who received dexmedetomidine for anesthesia/sedation in the surgical suite.

METHOD

Retrospective observational study, analyzing charts of patients ≥ 18 years submitted to anesthesia/sedation with dexmedetomidine, between 1/1/2017 and 31/12/2017. Upper temperature threshold was considered ≥ 37.8 °C, and lower, < 35 °C. The association with dexmedetomidine was assessed by the OMS/UMC causality system and by the Naranjo algorithm.

RESULTS

The sample included 42 patients who received dexmedetomidine and whose temperature data were available, with predominance of men 26 (62%), 49.4/16.5 years old (mean/standard deviation), and weight 65/35.8 kg. None of the patients presented intraoperative temperature equal to or above 37.8 °C or below 35 °C. During the postoperative period, one patient presented an increase ≥ 37.8 °C (2.4%) and three, temperature decrease < 35 °C (7%). Surgery/anesthesia time and exposure time to dexmedetomidine were not appropriate linear predictors of maximum temperature. Older age (p < 0.01), longer exposure to dexmedetomidine (p < 0.05) and shorter surgery time (p < 0.01) were significant linear predictors for lower minimum temperature.

CONCLUSIONS

Increase ≥ 37.8 °C/decrease < 35 °C of temperature possibly associated with dexmedetomidine did not occur in the intraoperative period and had a low frequency during the postoperative period.

摘要

介绍和目的

右美托咪定是一种强效的肾上腺素能 α-2 激动剂,具有镇痛、镇静、抗焦虑和交感神经抑制作用。鉴于已有关于右美托咪定相关体温变化的报告,这些事件与并发症有关,我们的目的是描述在手术室内接受右美托咪定麻醉/镇静的患者在围手术期(最初 24 小时)内体温升高和降低的情况,并分析相关因素。

方法

回顾性观察性研究,分析 2017 年 1 月 1 日至 12 月 31 日期间接受右美托咪定麻醉/镇静的年龄≥18 岁的患者的图表。上体温阈值定义为≥37.8°C,下体温阈值定义为<35°C。通过 OMS/UMC 因果关系系统和 Naranjo 算法评估与右美托咪定的关联。

结果

该样本包括 42 名接受右美托咪定且体温数据可用的患者,其中男性占主导地位,26 例(62%),49.4/16.5 岁(均值/标准差),体重 65/35.8kg。术中没有患者的体温等于或高于 37.8°C 或低于 35°C。在术后期间,1 名患者出现≥37.8°C 的体温升高(2.4%),3 名患者出现<35°C 的体温下降(7%)。手术/麻醉时间和暴露于右美托咪定的时间与最高体温无适当的线性相关性。年龄较大(p<0.01)、暴露于右美托咪定时间较长(p<0.05)和手术时间较短(p<0.01)是最低体温显著线性预测因素。

结论

术中未发生可能与右美托咪定相关的≥37.8°C 的体温升高/<35°C 的体温下降,术后期间的频率较低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6291/9373578/02a452eaec4a/gr1.jpg

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