Department of Surgical Anesthesia Center, LiHuili Hospital, Ningbo Medical Center, No.57 Xingning Road, Yinzhou District, Ningbo, 315000, Zhejiang Province, China.
Department of Surgical Anesthesia Center, the Second Hospital of Haishu District, No.52 Yizhi Middle Road, Shiqi Street, Haishu District, Ningbo, 315000, Zhejiang Province, China.
BMC Anesthesiol. 2022 Feb 7;22(1):40. doi: 10.1186/s12871-022-01577-w.
The study aimed at exploring an optimal temperature model of forced air warming during the first hour after induction and intraoperation to prevent hyperthermia for elderly patients undergoing laparoscopic abdominal surgery.
There were 218 patients that were randomly divided into 3 groups warmed with a forced-air warmer during surgery: Group L (intraoperative warming set to 38 °C, n = 63), Group H (intraoperative warming set to 42 °C, n = 65) and Group LH (intraoperative warming set to 42 °C for the first hour then set to 38 °C, n = 65). Core temperature in the preoperative room and PACU was measured by a tympanic membrane thermometer and in the operation room, a nasopharyngeal temperature probe was recorded. The rate of perioperative hypothermia, defined as a reduction in body temperature to < 36 °C was recorded as the primary outcome. Intraoperative anesthetic dosage, recovery time, adverse events, thermal comfort and satisfaction score were measured as secondary outcome.
The incidence of intraoperative and postoperative hypothermia was significantly lower in Group LH and Group H than Group L (18.75 and 15.62% vs 44.44%, P<0.001; 4.69 and 4.69% vs 20.63%, P<.05). Anesthetic dosage of rocuronium was lower in Group L than other two groups, with the opposite result of recovery time. The number of patients with shivering was higher in Group L but sweating was higher in Group H. Both of the thermal comfort and satisfaction score was highest in Group LH.
A temperature pattern of forced air warming set at 42 °C during the first hour after anesthesia induction and maintained with 38 °C was a suitable choice for elderly patients undergoing laparoscopic abdominal surgery lasting for more than 120 min.
Chictr.org.cn ChiCTR-2,100,053,211.
本研究旨在探讨一种用于预防老年腹腔镜腹部手术患者术中及术后早期体温过高的最佳空气加温模式。
将 218 例行腹腔镜腹部手术的患者随机分为三组，术中使用空气加温仪进行加温：L 组（术中设定加温目标温度为 38°C，n=63）、H 组（术中设定加温目标温度为 42°C，n=65）和 LH 组（术中前 1 小时设定加温目标温度为 42°C，然后设定为 38°C，n=65）。术前室和 PACU 采用鼓膜温度计测量核心温度，手术室采用鼻咽温度探头记录核心温度。主要结局为记录围术期低体温（体温降至<36°C）的发生率。次要结局包括术中麻醉剂量、苏醒时间、不良事件、热舒适度和满意度评分。
LH 组和 H 组术中及术后低体温的发生率明显低于 L 组（18.75%和 15.62%比 44.44%，P<0.001；4.69%和 4.69%比 20.63%，P<.05）。L 组的罗库溴铵麻醉剂量低于其他两组，而苏醒时间则相反。L 组寒战的患者较多，但 H 组出汗的患者较多。LH 组的热舒适度和满意度评分均最高。
对于超过 120 分钟的老年腹腔镜腹部手术患者，麻醉诱导后 1 小时内设定 42°C 的空气加温，然后维持 38°C 的加温模式是一种合适的选择。
Chictr.org.cn ChiCTR-2,100,053,211。
Zotero 插件