Castillo V, Gutiérrez-Crespo A, Suárez F, Luis-Navarro J C, Gómez-Argüelles M A
Servicio de Anestesiología, Reanimación y Terapia del Dolor, Hospital Universitario Virgen del Rocío, Sevilla.
Rev Esp Anestesiol Reanim. 1996 Jun-Jul;43(6):201-3.
To study changes over time in body temperature related to insufflation of CO2.
Fifty patients were randomly assigned to 2 groups of 25 to undergo cholecystectomy by either laparoscopy or laparotomy. Total intravenous anesthesia with propofol, pancuronium and fentanyl was used in both groups. Ventilation was maintained at 0.5 FiO2. Central temperature was continuously measured by a distal esophageal thermometer and results were recorded every 10 minutes in both groups. All operations lasted approximately 80 min.
We found that temperature gradually decreased over time in both groups. In the laparotomy group the decrease reached 0.20 degree C (SD 0.03) at 80 min. During laparoscopy the temperature decrease was 0.43 degree C (SD 0.04) for the same time period. The differences were statistically significant. We observed no pathophysiologic repercussions associated with these results.
Laparoscopic surgery, even when the abdominal cavity is not exposed to room air, induces a loss of temperature that is greater than that of laparotomy, because of insufflation of CO2 at 4 degrees C. The decrease was 0.4 degree C for every 50 l of CO2 insufflated during the study.
研究与二氧化碳气腹相关的体温随时间的变化。
50例患者随机分为两组，每组25例，分别接受腹腔镜胆囊切除术或开腹胆囊切除术。两组均采用丙泊酚、潘库溴铵和芬太尼全静脉麻醉。通气维持在0.5 FiO₂。用远端食管温度计连续测量中心温度，两组均每10分钟记录一次结果。所有手术持续约80分钟。
我们发现两组体温均随时间逐渐下降。开腹手术组在80分钟时体温下降达0.20℃（标准差0.03）。在腹腔镜手术期间，同一时间段体温下降为0.43℃（标准差0.04）。差异具有统计学意义。我们未观察到与这些结果相关的病理生理影响。
腹腔镜手术，即使腹腔未暴露于室温空气中，由于注入4℃的二氧化碳，导致体温下降幅度大于开腹手术。在研究过程中，每注入50升二氧化碳，体温下降0.4℃。
