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比较骨科手术患者椎管麻醉后使用空气加热和静脉输注加温液体对舒适度和预防寒战的效果。

Comparison of the Effect of Forced-air Warming and Warmed Intravenous Fluid on the Comfort and Prevention of Shivering After Spinal Anesthesia in Patients Undergoing Orthopedic Surgery.

机构信息

Naghavi Hospital, Kashan University of Medical Sciences, Kashan, Iran.

Surgical Technology Department, School of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran.

出版信息

J Perianesth Nurs. 2022 Dec;37(6):865-871. doi: 10.1016/j.jopan.2022.01.010. Epub 2022 Sep 1.

Abstract

PURPOSE

This study aimed to compare the effect of forced-air warming and warmed intravenous fluid on the comfort and prevention of shivering after spinal anesthesia in patients undergoing orthopaedic surgery.

DESIGN

Randomized controlled clinical trial.

METHODS

A total of 120 patients were randomly divided into three groups: forced-air warming (38°C), warmed intravenous fluid (37°C), and the control group. Patients' comfort and severity of shivering were measured and recorded five times (immediately and 15 minutes after spinal anesthesia, end of the surgery, time of entrance to the recovery room, and 15 minutes after entering the recovery room), and compared with each other.

FINDINGS

There was a significant difference between the three groups in terms of comfort at all points of evaluation times (P < .001). The comfort score in the control group was significantly higher than the two intervention groups (P < .001). Moreover, the comfort score in the warmed intravenous fluid group was significantly higher than the forced-air warming group (P < .001). In addition, there was a significant difference in shivering severity between the three groups at the end of the surgery, entrance to the recovery room, and 15 minutes after surgery (P < .001). The majority of patients in the forced-air warming group (90%) had no shivering at all three times, while the warmed IV fluid and control groups was 65% and 30% respectively.

CONCLUSIONS

Non-pharmacological methods such as forced-air warming and warmed intravenous fluid can provide comfort and prevent shivering in orthopaedic patients undergoing spinal anesthesia. However, the use of forced-air warming is more effective than warmed intravenous fluid in providing comfort and preventing shivering in these patients. It is recommended that these methods be used in the operating room to provide comfort and prevent shivering in these patients.

摘要

目的

本研究旨在比较空气加热和静脉加温对接受骨科手术的椎管内麻醉后患者舒适度和寒战预防的影响。

设计

随机对照临床试验。

方法

将 120 例患者随机分为三组:空气加热(38°C)、静脉加温(37°C)和对照组。测量并记录患者的舒适度和寒战严重程度,共 5 次(椎管内麻醉后即刻和 15 分钟、手术结束时、进入恢复室时和进入恢复室后 15 分钟),并进行相互比较。

结果

三组在所有评估时间点的舒适度均有显著差异(P <.001)。对照组的舒适度评分明显高于两组干预组(P <.001)。此外,静脉加温组的舒适度评分明显高于空气加热组(P <.001)。此外,三组在手术结束时、进入恢复室时和手术后 15 分钟时的寒战严重程度也有显著差异(P <.001)。空气加热组的大多数患者(90%)在这三个时间点均无寒战,而静脉加温组和对照组的患者分别为 65%和 30%。

结论

非药物方法如空气加热和静脉加温可提供骨科患者椎管内麻醉后的舒适度并预防寒战。然而,与静脉加温相比,空气加热在提供舒适度和预防这些患者寒战方面更有效。建议在手术室中使用这些方法为这些患者提供舒适度并预防寒战。

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