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全身麻醉下经尿道手术患者预热 10 分钟和输注预热静脉输液对中心体温的影响。

Effect of 10 Minutes of Prewarming and Prewarmed Intravenous Fluid Administration on the Core Temperature of Patients Undergoing Transurethral Surgery under General Anesthesia.

机构信息

Department of Anesthesiology and Pain Medicine, Inje University Sanggye Paik Hospital, Seoul, Korea.

Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Korea.

出版信息

Int J Med Sci. 2024 Jan 1;21(1):1-7. doi: 10.7150/ijms.88943. eCollection 2024.

Abstract

Patients undergoing transurethral urologic procedures using bladder irrigation are at increased risk of perioperative hypothermia. Thirty minutes of prewarming prevents perioperative hypothermia. However, its routine application is impractical. We evaluated the effect of 10 minutes of prewarming combined with the intraoperative administration of warmed intravenous fluid on patients' core temperature. Fifty patients undergoing transurethral bladder or prostate resection under general anesthesia were included in this study and were randomly allocated to either the control group or the prewarming group. Patients in the prewarming group were warmed for 10 minutes before anesthesia induction with a forced-air warming device and received warmed intravenous fluid during operations. The patients in control group did not receive preoperative forced-air warming and were administered room-temperature fluid. Participants' core body temperature was measured on arrival at the preoperative holding area (T), on entering the operating room, immediately after anesthesia induction, and in 10-minute intervals from then on until the end of the operation (T), on entering PACU, and in 10-minute intervals during the postanesthesia care unit stay. The groups' incidence of intraoperative hypothermia, change in core temperature (T - T), and postoperative thermal comfort were compared. The incidence of hypothermia was 64% and 29% in the control group and prewarming group, respectively (P = 0.015). Change in core temperature was 0.93 ± 0.3 °C and 0.55 ± 0.4 °C in the control group and prewarming group, respectively (P = 0.0001). Thermal comfort was better in the prewarming group (P = 0.004). Ten minutes of prewarming combined with warmed intravenous fluid significantly decreased the incidence of intraoperative hypothermia and resulted in better thermal comfort in patients undergoing transurethral urologic surgery under general anesthesia.

摘要

接受经尿道泌尿科手术的患者在围手术期有发生低体温的风险增加。 30 分钟的预热可预防围手术期低体温。 但是,其常规应用是不切实际的。 我们评估了 10 分钟预热联合术中输注加温静脉液体对患者核心体温的影响。 这项研究纳入了 50 例在全身麻醉下接受经尿道膀胱或前列腺切除术的患者,并将其随机分为对照组和预热组。 预热组患者在麻醉诱导前使用强制空气加热设备预热 10 分钟,并在手术期间输注加温静脉液体。 对照组患者在手术前不接受术前强制空气加热,并且输注室温液体。 在到达术前等候区时(T)、进入手术室时、麻醉诱导后立即以及此后每隔 10 分钟测量一次(T)、进入 PACU 时以及在麻醉后恢复期间每隔 10 分钟测量一次参与者的核心体温。 比较了两组术中低体温的发生率、核心体温变化(T - T)和术后热舒适度。 对照组和预热组的低体温发生率分别为 64%和 29%(P = 0.015)。 对照组和预热组的核心体温变化分别为 0.93 ± 0.3°C 和 0.55 ± 0.4°C(P = 0.0001)。 预热组的热舒适度更好(P = 0.004)。 10 分钟预热联合加温静脉液体可显著降低术中低体温的发生率,并改善全身麻醉下接受经尿道泌尿科手术患者的热舒适度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cd9/10750338/8a3c7e7505cf/ijmsv21p0001g001.jpg

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