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主动加热方法对全身麻醉期间体温、寒战、热舒适度、疼痛、恶心和呕吐的影响:一项随机对照试验

Effects of Active Heating Methods on Body Temperature, Shivering, Thermal Comfort, Pain, Nausea and Vomiting During General Anesthesia: A Randomized Controlled Trial.

作者信息

Şahin Akboğa Özlem, Gürkan Aysel

机构信息

Institute of Health Sciences, University of Marmara, Istanbul, Turkey.

Faculty of Health Sciences, University of Marmara, Istanbul, Turkey.

出版信息

Ther Hypothermia Temp Manag. 2024 Dec;14(4):269-281. doi: 10.1089/ther.2023.0049. Epub 2023 Nov 24.

Abstract

To investigate the effect of forced-air warming and heated intravenous (IV) and irrigation fluids alone and in combination on body temperature, shivering, thermal comfort, pain, nausea and vomiting in adult patients undergoing surgery under general anesthesia in a prospective, four-group, randomized controlled trial. After induction of anesthesia, 120 patients were divided into the following groups: patients warmed with forced-air warming ( = 30), patients receiving warmed IV and irrigation fluid ( = 30), patients receiving warmed IV and irrigation fluid with forced-air warming ( = 30), and the control group without any intervention ( = 30). Body temperature, shivering, thermal comfort, pain, nausea and vomiting were monitored in the first 24 hours after surgery. The general characteristics of the groups, mean body temperature, length of stay, ambient temperature, and duration of surgery in the preoperative waiting unit were similar ( > 0.05). Compared with the other groups, patients in the control group had a significant decrease in body temperature from the 30th minute during surgery ( < 0.001), lower body temperature in the first 2 hours and thermal comfort in the first three hours after surgery ( < 0.01), and higher shivering levels in the first hour after surgery ( < 0.01). There was no significant difference between the groups in terms of postoperative pain, nausea and vomiting ( > 0.05). The study findings showed that normothermia was maintained in all three intervention groups during the surgery and in the first 24 hours after surgery. Moreover, postoperative thermal comfort increased and shivering levels decreased compared with the control group, but pain, nausea and vomiting levels were not affected. The study was registered on ClinicalTrials.gov (NCT04907617).

摘要

在一项前瞻性、四组、随机对照试验中,研究强制空气加温、加热静脉输液和冲洗液单独及联合使用对全身麻醉下接受手术的成年患者体温、寒战、热舒适度、疼痛、恶心和呕吐的影响。麻醉诱导后,120例患者被分为以下几组:接受强制空气加温的患者(n = 30)、接受加温静脉输液和冲洗液的患者(n = 30)、接受加温静脉输液和冲洗液并同时进行强制空气加温的患者(n = 30)以及未进行任何干预的对照组(n = 30)。在术后的前24小时监测体温、寒战、热舒适度、疼痛、恶心和呕吐情况。各组的一般特征、平均体温、住院时间、环境温度以及术前等待病房的手术时长相似(P > 0.05)。与其他组相比,对照组患者在手术开始后第30分钟体温显著下降(P < 0.001),术后前2小时体温较低,术后前3小时热舒适度较低(P < 0.01);术后第1小时寒战程度较高(P < 0.01)。各组在术后疼痛、恶心和呕吐方面无显著差异(P > 0.05)。研究结果表明,所有三个干预组在手术期间及术后24小时内均维持了正常体温。此外,与对照组相比,术后热舒适度提高,寒战程度降低,但疼痛、恶心和呕吐程度未受影响。该研究已在ClinicalTrials.gov上注册(NCT04907617)。

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