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围手术期低温对乳腺手术拔管、恢复时间及术后寒战的影响

Effects of Perioperative Hypothermia on Extubation, Recovery Time, and Postoperative Shivering in Breast Surgery.

作者信息

Huniler Hatice Cansu, Deniz Mustafa Nuri, Günişen İlkben, Yakut Özdemir Özlem, Tetik Aslı, Ulukaya Sezgin

机构信息

Department of Anesthesiology and Reanimation, Ege University School of Medicine, Izmir, Turkey.

出版信息

Ther Hypothermia Temp Manag. 2024 Jun;14(2):110-117. doi: 10.1089/ther.2023.0037. Epub 2023 Aug 28.

Abstract

Women undergoing breast surgery seem to be under the risk for hypothermia (central body temperature <36°) due to the uncertainty caused by the preoperative preparation time and the variety of operations, leading to neglect of warming precautions. The study examines the perioperative hypothermia (PH) in breast surgery and the relationships between the depth of decrease in body temperature and individual or clinical variables. This prospective, cross-sectional, observational study includes 120 female patients 18-65 years of age who were given general anesthesia for breast surgery. The incidence of hypothermia was 68.1%. The given patients were discriminated as body temperature <36°, hypothermia was significantly related with lower weight, body mass index, American Society of Anesthesiology (ASA) score, baseline body temperatures, higher extubation, and recovery times. When patients' temperature decreases by >1 or 1.5°, lower age and longer durations of operation and anesthesia were also significant variables. The incidence of shivering is quite high at temperatures below 36°C or at 1 and 1.5°C reductions from baseline (72.7%, 84%, 94.1%, respectively). Body temperature changes of the patients had no effect on nausea-vomiting and pain scores. It turned out that the incidence of PH and shivering is high in women who underwent breast surgery. We think that the depth of decrease in body temperature should be taken into account when evaluating the predictors or clinical consequences of hypothermia, except for the 36°C limit for body temperature.

摘要

由于术前准备时间的不确定性和手术方式的多样性,接受乳房手术的女性似乎面临体温过低(中心体温<36°C)的风险,导致对保暖措施的忽视。本研究探讨了乳房手术围手术期体温过低(PH)情况以及体温下降深度与个体或临床变量之间的关系。这项前瞻性、横断面观察性研究纳入了120名年龄在18至65岁之间接受乳房手术全身麻醉的女性患者。体温过低的发生率为68.1%。将这些患者区分为体温<36°C,体温过低与较低体重、体重指数、美国麻醉医师协会(ASA)评分、基础体温、较高的拔管和恢复时间显著相关。当患者体温下降>1°C或1.5°C时,较低年龄以及较长的手术和麻醉持续时间也是显著变量。在体温低于36°C或比基线下降1°C和1.5°C时,寒战发生率相当高(分别为72.7%、8%、94.1%)。患者的体温变化对恶心呕吐和疼痛评分没有影响。结果表明,接受乳房手术的女性中PH和寒战的发生率较高。我们认为,在评估体温过低的预测因素或临床后果时,除了体温限制在36°C外,还应考虑体温下降的深度。

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