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首页> 外文期刊>The Internet Journal of Anesthesiology >The Effect Of Preoperative Reflective Hats And Jackets, And Intraoperative Reflective Blankets On Perioperative Temperature
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The Effect Of Preoperative Reflective Hats And Jackets, And Intraoperative Reflective Blankets On Perioperative Temperature

机译：术前反光帽子，夹克和术中反光毯对围手术期温度的影响

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Introduction: Mild perioperative hypothermia may delay awakening and increase recovery time. We addressed the effect of preoperative reflective hats and jackets, and intraoperative blankets on perioperative temperature. Methods: After IRB approval and written informed consent, we completed two studies. In Study One, fifty-two patients were randomly assigned to receive either reflective hats and jackets (Thermo-LiteTM) or not on their arrival in our outpatient surgery clinic. Immediately before surgery, hats and jackets were removed and patients were again randomly allocated to receive either a reflective blanket or a standard cloth blanket for intraoperative use. In Study Two, fifty-three patients were randomly assigned to receive either a reflective hat or not, again on arrival to our outpatient clinic. Reflective jackets and blankets were not used. In all patients, tympanic membrane temperature was measured at eight points: (1) on arrival in the outpatient department (Arrival); (2) in the holding area (Holding); (3) immediately on arrival in the OR (In OR); (4) 30 minutes after induction of anesthesia (Induction); (5) prior to leaving the OR (Out OR); (6) upon arrival in the PACU (In RR); (7) prior to discharge from the PACU (Out RR); (8)prior to discharge to home (Home). Data were analyzed by ANOVA using SPSSTM. Results: In Study One, there was a significant hat-jacket effect (p<0.01), but no significant blanket effect. However, patients using the reflective blankets were significantly warmer at Out OR, Out RR, and Home (p<0.05). In Study Two, both groups showed dips in temperature during surgery and recovery, but there was no significant effect of the hats alone.Conclusions: Our results indicate that the combined use of preoperative reflective hats and jackets, but not hats alone, significantly reduced temperature drop during outpatient surgery. Intraoperative reflective blankets had a small, but not significant, effect on temperature. We conclude that the prevention of intraoperative heat loss is provided by preoperative reflective hats and jackets, is not improved with intraoperative reflective blankets, and is more closely related to the total body surface area covered than which area is covered. Work done in the Department of Anesthesiology, LSUHSC ShreveportThis study was supported by the Department of Anesthesiology, LSUHSC Shreveport Introduction Hypothermia occurs in most anesthetized patients 1,2,3. Body heat loss occurs prior to anesthesia and rapidly after induction of anesthesia via four mechanisms: radiation, conduction, convection and evaporation 1-4, and intraoperative temperature decreases with the heat loss. Mild perioperative hypothermia, which is common during major surgery, may promote surgical-wound infection by triggering thermoregulatory vasoconstriction, which decreases subcutaneous oxygen tension 5,6. Wound healing can be delayed because of a reduction in the deposition of collagen 7. Moreover, adverse effects of hypothermia, such as cardiac complications, coagulation problems, and increased oxygen consumption can also occur 8.Outpatients frequently have to wait for some time before they are taken to the operating room for surgery. Similarly, patients may stay in the Post-Anesthesia Care Unit for a prolonged period of time while attempts are made to rewarm them. Prewarming has been shown to reduce the decrease in temperature observed with induction of epidural anesthesia 9,10.Many methods of intraoperative warming have been utilized to reduce heat loss. It has been said that the exposure of the head is the main source of heat loss due to its rich vascularity, and that covering the head can maintain the intraoperative temperature6. The purpose of these two studies was to ask and answer three questions: (1) Can reflective hats and jackets worn preoperatively decrease heat loss intraoperatively? (2) Do reflective blankets intraoperatively conserve heat any better than cloth blankets? (3) Will a reflec
机译：简介：轻度围手术期体温过低可能会延迟清醒并增加恢复时间。我们探讨了术前反光帽子和外套以及术中毯子对围手术期温度的影响。方法：经过IRB批准并获得知情同意书后，我们完成了两项研究。在研究一中，有52位患者被随机分配接受反光的帽子和夹克（Thermo-LiteTM），或者在到达我们的门诊外科诊所时不接受。手术前即刻，脱掉帽子和外套，并再次将患者随机分配到接受反射毯或标准布毯以供术中使用。在研究二中，有五十三名患者被随机分配到我们的门诊就诊时是否接受了反光帽子。没有使用反光外套和毯子。在所有患者中，对鼓膜温度进行了八个测量：（1）到达门诊部（到达）时; （2）在存放区（Holding）; （3）立即到达手术室（OR）; （4）麻醉诱导后30分钟（Induction）; （5）在离开OR（离开OR）之前; （6）到达PACU（在RR中）; （7）在从PACU出院之前（Out RR）; （8）在出院之前（Home）。使用SPSSTM通过ANOVA分析数据。结果：在研究一中，有显着的帽子夹克效应（p <0.01），但没有显着的毯子效应。但是，使用反光毯的患者在Out OR，Out RR和Home时明显变暖（p <0.05）。在研究二中，两组在手术和恢复期间均显示出温度下降，但仅使用帽子并没有明显效果。在门诊手术期间下降。术中反射毯对温度的影响很小，但不明显。我们得出的结论是，术前反光的帽子和外套可防止术中热量的流失，而术中的反光毯则无法改善术中的热量散失，而且与所覆盖的全身表面积相比，与所覆盖的表面积更紧密相关。 LSUHSC Shreveport麻醉科完成的这项研究得到LSUHSC Shreveport麻醉科的支持引言体温过低发生在大多数麻醉的患者1,2,3中。身体热量损失发生在麻醉之前，并且在麻醉诱导后迅速通过以下四种机制发生：辐射，传导，对流和蒸发1-4，并且术中温度随着热量损失而降低。轻度围手术期体温过低，这在大手术中很常见，它可能通过触发体温调节性血管收缩来促进手术伤口感染，从而降低皮下氧气张力5,6。由于胶原蛋白7的沉积减少，伤口愈合可能会延迟。此外，体温过低的不良反应（例如心脏并发症，凝血问题和耗氧量增加）也可能发生8。被带到手术室进行手术。同样，患者可能会在麻醉后护理病房中停留较长的时间，并试图对其进行撤防。预热已被证明可以减少由于硬膜外麻醉引起的体温下降[9,10]。许多术中加温的方法已被用来减少热量的损失。有人说，由于其丰富的血管，暴露于头部是热损失的主要来源，并且遮盖头部可以保持术中温度6。这两项研究的目的是要问和回答三个问题：（1）术前戴反光的帽子和夹克是否可以减少术中的热量损失？ （2）反射毯在术中是否比布毯更能节省热量？ （3）请问

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