Keneally Ryan J, Heinz Eric R, Jaffe Edward M, Niak Bhiken I, Canonico Andrew B, Roland Laura M, Chow Jonathan H, Mazzeffi Michael A
Department of Anesthesiology and Critical Care Medicine, George Washington University, Washington, DC, USA.
Department of Anesthesiology, University of Virginia, Charlottesville, Virginia, USA.
Proc (Bayl Univ Med Cent). 2024 Feb 23;37(3):424-430. doi: 10.1080/08998280.2024.2314443. eCollection 2024.
Our hypothesis was that total intravenous anesthesia (TIVA) is associated with an increase in hypothermia.
Inclusion criteria were patients from the National Anesthesia Clinical Outcomes Registry undergoing a general anesthetic during 2019. Data collected included patient age, sex, American Society of Anesthesiologists physical status classification system score (ASAPS), duration of anesthetic, use of TIVA, type of procedure, and hypothermia. Continuous variables were compared using Student's test or Mann Whitney rank sum as appropriate. Mixed effects multiple logistic regression was performed to determine the association between independent variables and hypothermia.
There was a low incidence of hypothermia (1.2%). Patients who became hypothermic were older, had a higher median ASAPS, and had a higher rate of TIVA. TIVA patients had a significantly increased odds for hypothermia when controlling for covariates. Patients undergoing obstetrical, thoracic, or radiological procedures had increased odds for hypothermia. In a matched cohort subset, TIVA was associated with a greater rate and increased odds for hypothermia.
The novel and noteworthy finding was the association between TIVA and perianesthesia hypothermia. Thoracic, radiologic, and obstetrical procedures were associated with greater rates of and odds for hypothermia. Other identified factors can help to stratify patients for risk for hypothermia.
我们的假设是全静脉麻醉(TIVA)与体温过低的发生率增加有关。
纳入标准为2019年期间在国家麻醉临床结果登记处接受全身麻醉的患者。收集的数据包括患者年龄、性别、美国麻醉医师协会身体状况分类系统评分(ASAPS)、麻醉持续时间、TIVA的使用、手术类型和体温过低情况。连续变量根据情况使用学生t检验或曼-惠特尼秩和检验进行比较。采用混合效应多元逻辑回归分析来确定自变量与体温过低之间的关联。
体温过低的发生率较低(1.2%)。体温过低的患者年龄较大,ASAPS中位数较高,TIVA使用率较高。在控制协变量后,接受TIVA的患者体温过低的几率显著增加。接受产科、胸科或放射科手术的患者体温过低的几率增加。在一个匹配队列亚组中,TIVA与体温过低的发生率更高及几率增加有关。
新的且值得注意的发现是TIVA与麻醉期间体温过低之间的关联。胸科、放射科和产科手术与体温过低的发生率更高及几率增加有关。其他已确定的因素有助于对患者体温过低的风险进行分层。