Comparison of efficacy of active forced-air warming for preventing perioperative hypothermia between the elderly and young patients

Wenping Peng, Shun Huang, Ning Yang
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Abstract

Objective To observe whether the active forced-air warming has the same efficacy on the prevention of perioperative hypothermia in the elderly as compared with young patients. Methods This was a prospective, randomized, controlled clinical trial.Forty patients scheduled for abdominal surgery under general anesthesia were allocated to two groups: the elderly group and the young group(n=20, each). All patients received active forced-air warming at 20-30 min before induction of anaesthesia till leaving the operation room.Blood products and peritoneal lavage fluids were warmed to 37℃, and other intravenous fluids were at room-temperature.The core temperatures were recorded after entering the operation room(baseline), before induction of anaesthesia, at 15 min intervals after induction of anaesthesia, at the end of surgery and before leaving the operation room.The postoperative shivering and adverse reactions were also recorded. Results The core temperature was lower in elderly patients than in young patients at baseline and at each time points after 30 min of induction of anaesthesia(P<0.05). In elderly patients, the core temperature was significantly lower before leaving operation room than at the baseline(t=2.353, P=0.03), but in young patients, no significant difference was found in the core temperature between at the baseline and before leaving operation room(t=0.233, P=0.818). The incidence of intra-operative hypothermia was higher in elderly patients than in young patients(40.0% or 8/20 vs.5.0% or 1/20, c2=7.025, P=0.008). Conclusions During abdominal surgery under general anesthesia, active forced-air warming cannot effectively prevent perioperative hypothermia in elderly patients as compared with young patients. Key words: Anesthesia, general; Body temperature regulation
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主动强制空气加热预防老年和青年围手术期低体温的疗效比较
目的观察主动强制空气加温对老年患者围手术期低温的预防效果是否与年轻患者相同。方法前瞻性、随机对照临床试验。将40例全麻下腹部手术患者分为老年组和青年组(各20例)。所有患者在诱导麻醉前20-30 min进行主动强制空气加热,直至离开手术室。血液制品和腹腔灌洗液加热至37℃,其他静脉输液室温。在进入手术室后(基线)、麻醉诱导前、麻醉诱导后每隔15分钟、手术结束时和离开手术室前记录核心温度。同时记录术后寒战及不良反应。结果麻醉诱导30 min后,老年患者在基线及各时间点的核心体温均低于年轻患者(P<0.05)。老年患者离院前核心体温明显低于基线时(t=2.353, P=0.03),青年患者离院时核心体温与基线时无显著差异(t=0.233, P=0.818)。老年患者术中低温发生率高于年轻患者(40.0%或8/20 vs.5.0%或1/20,c2=7.025, P=0.008)。结论在腹部全麻手术中,与年轻患者相比,主动强制空气加热不能有效预防老年患者围手术期低体温。关键词:麻醉;全身;体温调节
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