Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kitaku, Okayama 700-8558, Japan.
Medicina (Kaunas). 2023 Feb 17;59(2):395. doi: 10.3390/medicina59020395.
: Hypothermia frequently occurs in patients undergoing surgery and is associated with adverse complications. Therefore, this study aimed to investigate the postinduction blood glucose and occurrence of intraoperative hypothermia in patients undergoing laparoscopic surgery. : This retrospective observational study included 334 patients aged ≥20 years who had undergone elective laparoscopic surgery. The primary outcome of this study was the incidence of intraoperative hypothermia. Stratified analysis revealed differences between patients with and without diabetes. : Hypothermia occurred in 200 (59.9%) patients. In multivariate analysis, out-of-range postinduction glucose was independently associated with hypothermia (>150 mg/dL: odds ratio 2.17, 95% confidence interval (1.02, 4.61), = 0.045; <110 mg/dL: odds ratio 2.02, 95% confidence interval (1.15, 3.55), = 0.015), whereas preoperative HbA1c >6% was not significantly associated with hypothermia (odds ratio 1.02, 95% confidence interval (0.56, 1.84), = 0.961). Considering only patients with diabetes, the incidence of hypothermia was lower ( = 0.002), the duration of hypothermia was shorter ( = 0.007), and the minimum temperature was higher ( = 0.006) in those with a postinduction glucose level of 110-150 mg/dL. : The postinduction glucose level is independently associated with intraoperative hypothermia. Out-of-range postinduction glucose appeared to have an impact on the development of hypothermia in patients with diabetes, especially those with a postinduction glucose level <110 mg/dL.
术中低体温在接受手术的患者中很常见，并且与不良并发症有关。因此，本研究旨在探讨接受腹腔镜手术的患者在诱导后血糖和术中低体温的发生情况。
本回顾性观察性研究纳入了 334 名年龄≥20 岁的择期腹腔镜手术患者。本研究的主要结局是术中低体温的发生率。分层分析显示了有糖尿病和无糖尿病患者之间的差异。
有 200 名（59.9%）患者发生低体温。在多变量分析中，诱导后血糖超出范围与低体温独立相关（>150mg/dL：比值比 2.17，95%置信区间[1.02，4.61]， = 0.045；<110mg/dL：比值比 2.02，95%置信区间[1.15，3.55]， = 0.015），而术前 HbA1c >6%与低体温无显著相关性（比值比 1.02，95%置信区间[0.56，1.84]， = 0.961）。仅考虑糖尿病患者，低体温发生率较低（ = 0.002），低体温持续时间较短（ = 0.007），且 110-150mg/dL 诱导后血糖水平患者的最低温度较高（ = 0.006）。
诱导后血糖水平与术中低体温独立相关。血糖超出范围可能对糖尿病患者低体温的发生产生影响，尤其是那些诱导后血糖水平<110mg/dL 的患者。
