Camus Y, Delva E, Just B, Lienhart A
Department of Anesthesiology and Intensive Care, Saint-Antoine Hospital, Paris, France.
Anesth Analg. 1993 Nov;77(5):995-9. doi: 10.1213/00000539-199311000-00021.
The efficacy of leg skin warming in preventing hypothermia and shivering was evaluated in two separate prospective, randomized trials in patients undergoing abdominal surgery. In the first trial, 22 patients were randomized to receive no hypothermia prevention (control group) or active warming with an electric warming blanket (electric blanket group). In the second trial 33 patients were randomized to receive no hypothermia prevention (control group) or forced-air warming (Bair Hugger group) or forced-air warming with insulation of the air blanket from the environment (insulated Bair Hugger group). The core and skin temperatures were measured and changes in body heat content calculated. In the first trial, core temperature was 34.6 +/- 0.3 degrees C at the end of surgery in the control group vs 36.4 +/- 0.1 degrees C in the electric warming blanket group (P < 0.001). Shivering occurred in nine control patients and in one warmed patient (P < 0.05). In the second trial, core temperature was 35.1 +/- 0.2 degrees C at the end of surgery in the control group, 36.3 +/- 0.1 degrees C in the Bair Hugger group (P < 0.01) and 37.1 +/- 0.1 degrees C in the insulated Bair Hugger group (P < 0.01 versus control; P < 0.05 versus Bair Hugger). Shivering occurred in one patient of each warmed group and in seven of the control group (P < 0.05). Skin-surface warming limited to the legs provides sufficient heat (ranging 34 to 43 watts) to counterbalance heat losses during abdominal surgery.
在两项针对接受腹部手术患者的前瞻性随机试验中，对腿部皮肤升温预防体温过低和寒战的效果进行了评估。在第一项试验中，22名患者被随机分为不采取体温过低预防措施的组（对照组）或使用电暖毯进行主动升温的组（电暖毯组）。在第二项试验中，33名患者被随机分为不采取体温过低预防措施的组（对照组）、强制空气升温组（Bair Hugger组）或对空气毯进行环境隔热的强制空气升温组（隔热Bair Hugger组）。测量了核心温度和皮肤温度，并计算了身体热量含量的变化。在第一项试验中，对照组手术结束时的核心温度为34.6±0.3℃，而电暖毯组为36.4±0.1℃（P<0.001）。9名对照组患者和1名升温患者出现了寒战（P<0.05）。在第二项试验中，对照组手术结束时的核心温度为35.1±0.2℃，Bair Hugger组为36.3±0.1℃（P<0.01），隔热Bair Hugger组为37.1±0.1℃（与对照组相比P<0.01；与Bair Hugger组相比P<0.05）。每个升温组各有1名患者出现寒战，而对照组有7名患者出现寒战（P<0.05）。仅对腿部进行皮肤表面升温可提供足够的热量（范围为34至43瓦），以抵消腹部手术期间的热量损失。
