Department of Anesthesiology and Pain Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul 01757, Republic of Korea.
Medicina (Kaunas). 2024 Apr 30;60(5):747. doi: 10.3390/medicina60050747.
: Transurethral urologic surgeries frequently lead to hypothermia due to bladder irrigation. Prewarming in the preoperative holding area can reduce the risk of hypothermia but disrupts surgical workflow, preventing it from being of practical use. This study explored whether early intraoperative warming during induction of anesthesia, known as peri-induction warming, using a forced-air warming device combined with warmed intravenous fluid could prevent intraoperative hypothermia. : Fifty patients scheduled for transurethral resection of the bladder (TURB) or prostate (TURP) were enrolled and were randomly allocated to either the peri-induction warming or control group. The peri-induction warming group underwent whole-body warming during anesthesia induction using a forced-air warming device and was administered warmed intravenous fluid during surgery. In contrast, the control group was covered with a cotton blanket during anesthesia induction and received room-temperature intravenous fluid during surgery. Core temperature was measured upon entrance to the operating room (T), immediately after induction of anesthesia (T), and in 10 min intervals until the end of the operation (T). The incidence of intraoperative hypothermia, change in core temperature (T-T), core temperature drop rate (T-T/[duration of anesthesia]), postoperative shivering, and postoperative thermal comfort were assessed. : The incidence of intraoperative hypothermia did not differ significantly between the two groups. However, the peri-induction warming group exhibited significantly less change in core temperature (0.61 ± 0.3 °C vs. 0.93 ± 0.4 °C, = 0.002) and a slower core temperature drop rate (0.009 ± 0.005 °C/min vs. 0.013 ± 0.004 °C/min, = 0.013) than the control group. The peri-induction warming group also reported higher thermal comfort scores ( = 0.041) and less need for postoperative warming ( = 0.034) compared to the control group. : Brief peri-induction warming combined with warmed intravenous fluid was insufficient to prevent intraoperative hypothermia in patients undergoing urologic surgery. However, it improved patient thermal comfort and mitigated the absolute amount and rate of temperature drop.
经尿道泌尿科手术常因膀胱冲洗而导致体温过低。在术前等待区进行预加热可以降低体温过低的风险,但会打乱手术流程,使其无法实际应用。本研究探讨了在麻醉诱导期间进行早期术中加热(称为诱导前加热),使用强制空气加热设备和加热的静脉输液是否可以预防术中体温过低。
五十名计划接受经尿道膀胱切除术(TURB)或前列腺切除术(TURP)的患者入组,并随机分配至诱导前加热组或对照组。诱导前加热组在全身麻醉诱导期间使用强制空气加热设备进行全身加热,并在手术期间给予加热的静脉输液。相比之下,对照组在麻醉诱导时覆盖棉毯,并在手术期间给予室温静脉输液。在进入手术室时(T)、麻醉诱导后即刻(T)以及手术结束前每 10 分钟测量一次核心体温(T)。评估术中低体温的发生率、核心体温变化(T-T)、核心体温下降率(T-T/[麻醉持续时间])、术后寒战和术后热舒适度。
两组术中低体温的发生率无显著差异。然而,诱导前加热组的核心体温变化明显较小(0.61 ± 0.3°C 比 0.93 ± 0.4°C, = 0.002),核心体温下降率较慢(0.009 ± 0.005°C/min 比 0.013 ± 0.004°C/min, = 0.013)。与对照组相比,诱导前加热组报告的热舒适度评分更高( = 0.041),术后需要升温的需求更少( = 0.034)。
简短的诱导前加热联合加热的静脉输液不足以预防泌尿科手术患者的术中低体温。然而,它改善了患者的热舒适度,并减轻了体温下降的绝对值和速度。