Department of Anaesthesia, Tampere University Hospital, Tampere, Finland.
Department of Anaesthesia, Tays Hatanpää, Tampere University Hospital, Tampere, Finland.
Acta Anaesthesiol Scand. 2021 Feb;65(2):176-181. doi: 10.1111/aas.13714. Epub 2020 Oct 7.
Inadvertent intraoperative hypothermia is a common occurrence in surgical patients. A thermal suit is an option for passive insulation. However, active warming is known to be more effective. Therefore, we hypothesised that a forced-air warming (FAW) unit connected to the thermal suit is superior to a commercial FAW blanket and a warming mattress in breast cancer surgery.
Forty patients were randomised to this prospective, clinical trial to wear either the thermal suit or conventional hospital clothes under general anaesthesia. The Thermal suit group had a FAW unit set to 38°C and connected to the legs of the suit. The Hospital clothes group had a lower body blanket set to 38°C and a warming mattress set to 37°C. Core temperature was measured with zero-heat-flux sensor. The primary outcome was core temperature on admission to the recovery room.
There was no difference in mean core temperatures at anaesthetic induction (P = .4) or on admission to the recovery room (P = .07). One patient in the Thermal suit group (5%) vs six patients in the Hospital clothes group (32%) suffered from intraoperative hypothermia (P = .04, 95% CI 1.9%-49%). Mean skin temperatures (MSTs) were higher in the Thermal suit group during anaesthesia. No burns or skin irritations were reported. Two patients in the Thermal suit group sweated.
A thermal suit connected to a FAW unit was not superior to a commercial FAW blanket, although the incidence of intraoperative hypothermia was lower in patients treated with a thermal suit.
在手术患者中,术中意外低体温是一种常见现象。热套是被动保温的一种选择。然而,主动加热被认为更有效。因此,我们假设与热套连接的强制空气加热(FAW)装置在乳腺癌手术中优于商业 FAW 毯和加热床垫。
40 名患者被随机分配到这项前瞻性临床试验中,在全身麻醉下穿热套或常规医院服。热套组将 FAW 装置设置为 38°C 并连接到套装的腿部。医院衣服组将下半身毯子设置为 38°C 并将加热床垫设置为 37°C。使用零热通量传感器测量核心温度。主要结局是进入恢复室时的核心温度。
麻醉诱导时(P=0.4)或进入恢复室时(P=0.07)的平均核心温度无差异。热套组 1 名患者(5%)与医院衣服组 6 名患者(32%)发生术中低体温(P=0.04,95%CI 1.9%-49%)。麻醉期间热套组的平均皮肤温度(MST)较高。未报告烧伤或皮肤刺激。热套组有 2 名患者出汗。
与商业 FAW 毯相比,与 FAW 装置连接的热套并没有优势,尽管使用热套的患者术中低体温的发生率较低。