Murat I, Bernière J, Constant I
Department of Pediatric Anesthesia, Hospital Armand Trousseau, Paris, France.
J Clin Anesth. 1994 Sep-Oct;6(5):425-9. doi: 10.1016/s0952-8180(05)80016-9.
To evaluate the efficacy of a forced-air warmer during spinal surgery for correction of scoliosis in children.
Prospective randomized study (group allocation based on the availability of the warming device).
Children's teaching hospital.
51 ASA physical status I and II children (mean age, 15 years; mean weight, 45 kg) scheduled for posterior spinal fusion with general anesthesia.
Study group (warmed; n = 26)--legs covered with the forced-air warmer (Bair Hugger, Augustine Medical, Inc., Eden Prairie, MN) after installation of the patient in prone position--versus control group (n = 25)--400W heat lamp placed over the head during surgery as is usually done in our institution.
Rectal temperature was taken every 15 minutes during surgery and during the first 2 hours in the recovery room. Time required for the wake-up test, time to extubation, and blood loss also were noted. Temperature profiles were very different in the 2 groups. In the control group, rectal temperature decreased during the first 180 minutes to a minimum of 34.8 degrees C +/- 0.6 degrees C, followed by a slow rewarming phase. In the warmed group, the lowest temperature (35.6 degrees C +/- 0.5 degrees C) was recorded 45 minutes after placement of the forced-air warmer, followed by an effective warming phase. At the end of surgery, temperature was significantly higher in the warmed group than in the control group (36.5 degrees C +/- 0.8 degrees C vs. 35.4 degrees C +/- 0.9 degrees C). However, time required for the wake-up test, time to extubation, and blood loss did not differ between groups.
The forced-air warmer (Bair Hugger) is effective during spinal surgery, although only about 20% of body surface area can be covered.
评估儿童脊柱侧弯矫正手术中使用强制空气加温器的效果。
前瞻性随机研究（根据加温设备的可用性进行分组）。
儿童教学医院。
51例ASA身体状况为I级和II级的儿童（平均年龄15岁；平均体重45千克），计划接受全身麻醉下的后路脊柱融合术。
研究组（加温组；n = 26）——患者俯卧位安置后，腿部用强制空气加温器（Bair Hugger，奥古斯汀医疗公司，明尼苏达州伊甸草原）覆盖——对照组（n = 25）——手术期间按我院常规，在头部上方放置400W的加热灯。
手术期间及恢复室的前2小时内，每15分钟测量一次直肠温度。记录苏醒测试所需时间、拔管时间和失血量。两组的温度曲线差异很大。对照组中，直肠温度在最初180分钟内降至最低34.8℃±0.6℃，随后是缓慢复温阶段。加温组中，放置强制空气加温器45分钟后记录到最低温度（35.6℃±0.5℃），随后是有效加温阶段。手术结束时，加温组的温度显著高于对照组（36.5℃±0.8℃对35.4℃±0.9℃）。然而，两组间苏醒测试所需时间、拔管时间和失血量并无差异。
强制空气加温器（Bair Hugger）在脊柱手术中有效，尽管只能覆盖约20%的体表面积。
