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预先使用太空毯可减少全身麻醉后的寒战。

Pre-emptive use of the space blanket reduces shivering after general anaesthesia.

作者信息

Buggy D, Hughes N

机构信息

Department of Anaesthesia and Intensive Care Medicine, St James' Hospital, Dublin, Ireland.

出版信息

Br J Anaesth. 1994 Apr;72(4):393-6. doi: 10.1093/bja/72.4.393.

Abstract

We have investigated the role of aluminized metal foil (space blanket, UN 320), used pre-emptively, in post-anaesthetic shivering and patients' subjective perception of cold after general anaesthesia of short duration. Sixty-eight ASA I and II patients undergoing orthopaedic and plastic surgery on the peripheries were allocated randomly to two groups: those in group 1 were wrapped (not less than 60% of body surface area) in the space blanket before induction of anaesthesia. In group 2 patients had standard surgical draping. In all subjects, anaesthesia was induced with fentanyl and propofol, and maintained with nitrous oxide and enflurane in oxygen, after a laryngeal mask airway was positioned. Patients were asked to grade their perception of cold on a visual analogue scale, before induction and on recovery. Skin (dorsum of hand) and core (nasopharyngeal) temperatures were recorded at 15-min intervals. Occurrence of shivering and cold scores were recorded by blinded observers. Groups were similar in age and gender; duration of anaesthesia was also similar (mean 41.6 (SEM 4.8) vs 47.5 (3.3) min, respectively). The incidences of shivering were 15% and 63% in groups 1 and 2, respectively (P < 0.001). Cold scores were 2.4 (0.4) and 5.7 (0.5), respectively (P < 0.001). Skin temperatures increased with increasing duration of anaesthesia in both groups but were greater at 15, 30 and 45 min in group 1 (33.38 (0.25) vs 31.56 (0.31), 34.46 (0.25) vs 32.45 (0.31) and 35.22 (0.36) vs 33.13 (0.34), respectively; P < 0.001 each comparison). Core temperature increased slightly in group 1 and decreased in group 2 (P = 0.11).(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

我们研究了预先使用镀铝金属箔(太空毯,联合国编号320)在短时间全身麻醉后预防麻醉后寒战及患者主观冷感方面的作用。68例接受外周骨科和整形手术的美国麻醉医师协会(ASA)I级和II级患者被随机分为两组:第1组患者在麻醉诱导前用太空毯包裹(覆盖体表面积不少于60%)。第2组患者采用标准手术铺巾。所有受试者均通过芬太尼和丙泊酚诱导麻醉,并在置入喉罩气道后用氧化亚氮和安氟醚加氧气维持麻醉。要求患者在诱导前及苏醒时用视觉模拟评分法对其冷感进行分级。每隔15分钟记录皮肤(手背)和核心(鼻咽)温度。由不知情的观察者记录寒战的发生情况和冷感评分。两组患者的年龄和性别相似;麻醉持续时间也相似(分别为平均41.6(标准误4.8)分钟和47.5(3.3)分钟)。第1组和第2组的寒战发生率分别为15%和63%(P<0.001)。冷感评分分别为2.4(0.4)和5.7(0.5)(P<0.001)。两组患者的皮肤温度均随麻醉时间延长而升高,但第1组在15、30和45分钟时更高(分别为33.38(0.25)对31.56(0.31)、34.46(0.25)对32.45(0.31)和35.22(0.36)对33.13(0.34);每次比较P<0.001)。第1组的核心温度略有升高,第2组则降低(P=0.11)。(摘要截短于250字)

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