Estebe J P, Le Naoures A, Malledant Y, Ecoffey C
Département d'Anesthésie Réanimation Chirurgical, Centre Hospitalier Régional, Rennes, France.
Br J Anaesth. 1996 Dec;77(6):786-8. doi: 10.1093/bja/77.6.786.
Twenty-six patients requiring orthopaedic surgery were anaesthetized and oesophageal and rectal temperature were monitored continuously. Twenty patients requiring a pneumatic tourniquet were allocated prospectively to one of two groups: passive group (Pg) with reflective insulation on all available skin surface (n = 10) and forced group (Fg), with active warming by a forced air system (n = 10). Six patients without a tourniquet were used as a reference group (Rg). The pneumatic tourniquet time was similar in the tourniquet groups. During tourniquet inflation, oesophageal temperature increased with time. The difference was significant compared with the reference group at approximately 20 min. At about 30 min, oesophageal temperature in group Fg was significantly higher than that in group Pg. After tourniquet deflation, temperature decreased transiently. Changes in rectal temperature were similar but delayed significantly. A mechanism to explain the increase in core temperature during pneumatic tourniquet use remains unclear. A redistribution mechanism by cooling of the blood in a cold and vasodilated limb could explain the decrease of temperature after tourniquet deflation.
26例需要接受骨科手术的患者接受了麻醉，并持续监测食管和直肠温度。20例需要使用气动止血带的患者被前瞻性地分为两组：被动组（Pg），所有可用皮肤表面均采用反射隔热措施（n = 10）；强制组（Fg），采用强制空气系统进行主动加温（n = 10）。6例未使用止血带的患者作为参照组（Rg）。止血带组的气动止血带使用时间相似。在止血带充气期间，食管温度随时间升高。与参照组相比，大约20分钟时差异显著。大约30分钟时，Fg组的食管温度显著高于Pg组。止血带放气后，温度短暂下降。直肠温度变化相似但明显延迟。关于气动止血带使用期间核心温度升高的机制仍不清楚。肢体寒冷且血管扩张时血液冷却导致的再分布机制可以解释止血带放气后温度的下降。
