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氨基酸输注对髋关节置换术脊髓麻醉期间体温过低的预防效果评估。

Evaluation of Amino Acid Infusion preventive effect on Hypothermia during Spinal Anesthesia for Hip Arthroplasty.

作者信息

Alipour Mohammad, Taghavi Gillani Mehryar, Bameshki Alireza, Razavi Majid, Mashhadi Leila, Amiriani Marjan, Peivandi Yazdi Arash

机构信息

Department of Anesthesiology, Faculty of medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Lung Disease Research Center, Department of Anesthesiology, Mashhad University of Medicine Sciences, Mashhad, Iran.

出版信息

Arch Bone Jt Surg. 2022 Jul;10(7):627-632. doi: 10.22038/ABJS.2022.54665.2724.

Abstract

BACKGROUND

Hypothermia increases bleeding during surgery, risk of ischemic heart disease and postoperative wound infection. Intravenous amino acid increases cell synthesis and produces heat. Our goal was evaluating of the effect of amino acid on intraoperative hypothermia under spinal anesthesia.

METHODS

This is a randomized, double-blinded clinical trial that 36 adults undergoing Hip Arthroplasty were randomly assigned into two groups of 18 each. One group received Amino Acids solution (Aminoven 10%) 500ml (240ml/h) throughout spinal anesthesia, and control group received saline solution. We measured core body temperature, MAP and HR each 10 minutes, and also postoperative shivering, blood loss, operation time, postoperative BUN and Cr were compared in two groups.

RESULTS

Throughout surgery, the reduction in core temperature was more in the control group than the amino acids group (statistically not clinically). The decrease in core temperature was significantly larger in the controls (0.96°C ± 0.7°C) than in the amino acid patients (0.94°C ± 0.4°C), (P value= 0.02). Postoperative shivering was 73% in the controls regarding 11% in the amino acids patients. Overall, there were no significant statistical differences between other variables that we measured in two groups of patients.

CONCLUSION

Amino acids infusion during spinal anesthesia exerted a thermogenic effect. Our findings showed hypothermia was less in the aminoacid group, and also postoperative shivering was more in the control group.

摘要

背景

体温过低会增加手术期间的出血量、缺血性心脏病风险和术后伤口感染风险。静脉输注氨基酸可促进细胞合成并产生热量。我们的目标是评估氨基酸对脊髓麻醉下术中体温过低的影响。

方法

这是一项随机、双盲临床试验,36例接受髋关节置换术的成年人被随机分为两组,每组18人。一组在整个脊髓麻醉过程中接受500ml(240ml/h)的氨基酸溶液(10%凡命),对照组接受生理盐水溶液。我们每10分钟测量一次核心体温、平均动脉压和心率,同时比较两组患者术后的寒战、失血量、手术时间、术后血尿素氮和肌酐。

结果

在整个手术过程中,对照组核心体温的下降幅度大于氨基酸组(统计学上无临床意义)。对照组核心体温的下降幅度(0.96°C±0.7°C)明显大于氨基酸组患者(0.94°C±0.4°C),(P值=0.02)。对照组术后寒战发生率为73%,而氨基酸组患者为11%。总体而言,我们在两组患者中测量的其他变量之间没有显著的统计学差异。

结论

脊髓麻醉期间输注氨基酸具有产热作用。我们的研究结果表明,氨基酸组体温过低的情况较少,且对照组术后寒战更为明显。

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Perioperative thermoregulation and temperature monitoring.围手术期体温调节与体温监测
Anesthesiol Clin. 2006 Dec;24(4):823-37. doi: 10.1016/j.atc.2006.09.001.

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