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[不同麻醉程序下在层流气流手术室中的中心体温变化过程]

[Course of central body temperature in the laminar airflow operating room in various anesthesia procedures].

作者信息

Kochs E, Blanc I, Pfeifer G

出版信息

Anasth Intensivther Notfallmed. 1986 Aug;21(4):203-6.

PMID:3752428
Abstract

The oesophageal body temperature of 130 patients was measured pre- and intraoperatively. 92% (n = 116) of the operations (implantation or replacement of hip prostheses) were performed in an operating room having a laminar air flow system with horizontal air flow. 9% (n = 14) of the operations (laparotomies) were performed in a room of identical design without an air circulation system. Three different forms of anesthesia were investigated with regard to their influence on interior body temperature: 1) general anesthesia with a volatile anesthetic (INH); 2) peridural anesthesia with additional general anesthesia (KPDA+ITN); and 3) neuroleptic anesthesia (NLA). A drop in temperature during the operation was found in all patients. In the conventional operating room the mean drop was 0.3 degrees C/h. In the operating room with laminar air flow the INH-patients sustained the greatest decrease in temperature; the mean value in the first hour was 1.1 degrees C/h, and up to 4.6 degrees C/3 h toward the end of the operation. There was a comparable drop in temperature in the first hour in patients anesthetized with KPDA+ITN, but the rate slowed down toward the end of the investigation (2.2 degrees C/3 h). NLA caused a characteristic temperature behavior, with an initial fall in temperature, plateau phase, and subsequent rise (total: -1.0 degrees C/3 h) Temperature regulation was influenced least by NLA in the operating room with laminar air flow; thus, in this context, NLA proved to be a favourable form of anesthesia.

摘要

对130例患者的食管体温进行了术前和术中测量。92%(n = 116)的手术(髋关节假体植入或置换)在具有水平气流的层流空气流动系统的手术室中进行。9%(n = 14)的手术(剖腹手术)在设计相同但没有空气循环系统的房间中进行。研究了三种不同麻醉方式对体内温度的影响:1)挥发性麻醉剂全身麻醉(INH);2)硬膜外麻醉加全身麻醉(KPDA + ITN);3)神经安定麻醉(NLA)。所有患者在手术期间均出现体温下降。在传统手术室中,平均体温下降速度为每小时0.3摄氏度。在具有层流空气流动的手术室中,接受INH麻醉的患者体温下降幅度最大;第一小时的平均值为每小时1.1摄氏度,手术结束时高达每3小时4.6摄氏度。接受KPDA + ITN麻醉的患者在第一小时体温下降幅度相当,但在研究结束时下降速度减慢(每3小时2.2摄氏度)。NLA导致了一种特征性的体温变化,先是体温下降,然后是平台期,随后上升(总计:每3小时 -1.0摄氏度)。在具有层流空气流动的手术室中,NLA对体温调节的影响最小;因此,在这种情况下,NLA被证明是一种有利的麻醉方式。

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