Department of Anaesthesiology and Pain Medicine, Konyang University Hospital, Konyang University Myunggok Medical Research Institute, Konyang University College of Medicine, Daejeon, Korea.
Department of Anaesthesiology and Pain Medicine, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea.
Int J Med Sci. 2023 Oct 24;20(13):1774-1782. doi: 10.7150/ijms.89671. eCollection 2023.
Hypothermia is common in patients undergoing urological surgery; however, no single preventative modality is completely effective. This study evaluated the effects of combining prewarming with intraoperative phenylephrine infusion for the prevention of hypothermia in patients undergoing urological surgery. This prospective study enrolled 58 patients scheduled for urological surgery under general anesthesia. The patients were randomized into two groups (n = 29). Patients in the experimental (prewarming and phenylephrine infusion) group (PP group) received prewarming for 20 min and intraoperative phenylephrine infusion, whereas those in the control group (C group) received no active prewarming with only intermittent administration of vasoactive agents. The patient's sublingual temperatures before and after anesthesia and nasopharyngeal temperature during anesthesia were recorded as core temperatures. The incidence of intraoperative hypothermia was higher in the C group than in the PP group (57.7% [15/26] vs. 23.1% [6/26], = 0.01). The severity of intraoperative hypothermia was higher in the C group than in the PP group ( = 0.004). The nasopharyngeal temperature at the end of surgery was lower in the C group than in the PP group (35.8 ± 0.6°C vs. 36.3 ± 0.4°C, = 0.002). The trend of core temperature decline during the first hour after anesthesia induction differed between the two groups ( = 0.003; its decline was more gradual in the PP group). The combination of prewarming for 20 min and intraoperative phenylephrine infusion reduced the incidence and severity of intraoperative hypothermia and modified the trend of decreasing core temperatures in patients undergoing urological surgery.
术中低体温在泌尿科手术患者中很常见；然而，没有单一的预防方法是完全有效的。本研究评估了在泌尿科手术患者中联合使用预加温与术中去氧肾上腺素输注预防低体温的效果。本前瞻性研究纳入了 58 例行全身麻醉下泌尿科手术的患者。患者被随机分为两组（n = 29）。实验组（预加温+去氧肾上腺素输注组，PP 组）接受 20 分钟预加温及术中去氧肾上腺素输注，而对照组（C 组）仅接受间歇性血管活性药物治疗，不进行主动预加温。记录患者麻醉前和麻醉后的舌下温度以及麻醉期间的鼻咽温度作为核心温度。C 组术中低体温的发生率高于 PP 组（57.7%[15/26]比 23.1%[6/26]， = 0.01）。C 组术中低体温的严重程度高于 PP 组（ = 0.004）。C 组手术结束时的鼻咽温度低于 PP 组（35.8 ± 0.6°C 比 36.3 ± 0.4°C， = 0.002）。两组患者麻醉后 1 小时内核心温度下降趋势不同（ = 0.003；PP 组下降更缓慢）。20 分钟预加温与术中去氧肾上腺素输注联合使用可降低泌尿科手术患者术中低体温的发生率和严重程度，并改变核心温度下降的趋势。
