Effects of two different anesthesia methods on temperature, perfusion index and coagulation function / 中国基层医药

Objective@#To observe the effects of general anesthesia and intravertebral anesthesia on the patients' temperature, perfusion index(PI) and coagulation function.@*Methods@#From January 2016 to December 2017, 60 patients in the First Hospital of Jiaxing undergoing elective line of great saphenous varicose veins surgery were selected.According to the random number table, the patients were divided into the general anesthesia group(group G, n=30) and intraspinal anesthesia group(group I, n=30). The general condition, operation time, the core temperature(tympanic membrane temperature) before anesthesia(T0), 10 min after anesthesia(T1), 20 min later(T2), 30 min later(T3), and the PI with no-infusion upper limb were recorded.The changes of coagulation function before anesthesia(T0) and after surgery(T4) were observed by extraction of the thrombus(TEG).@*Results@#The core body temperature of T1, T2 and T3 was significantly decreased in both two groups(FG=58.789, P=0.000, FI=2.965, P=0.035), and the hypothermia of group G was greater than that of group I(t1=-2.998, t2=-5.985, t3=-7.705; P<0.05). The PI of T1, T2 and T3 was significantly higher than T0 in both two groups(FG=5.439, P=0.002, FI=3.404 P=0.020), and the increase of group G was greater than that of group I(t1=2.065, t2=2.041, t3=2.649; P<0.05). In group G, TEG examination was significantly prolonged(F=5.482, P=0.023), and no significant changes were observed in group I.@*Conclusion@#The hypothermia of the patients and the increase of PI increased significantly, and the R time index of TEG is prolonged, and the anesthesia in the spinal canal has no obvious effect on the coagulation function.

Comparison of rectal, axillary, abdominal skin and tympanic membrane temperature measurements in term and preterm neonates.

A quasi-experimenal study was conducted to investigate the optimum time and accuracy of temperature measurements from four sites: rectum (2.5 cm and 3 cm beyond the anus in preterm and term neonates, respectively), axilla (with mercury-in-glass thermometers), abdominal skin (with Duotemp Temperature Monitor), and tympanic membrane (with FirstTemp Genius Infrared Tympanic Thermo-meter in the rectal-equivalent mode). A convenience sampling technique was utilized to enroll 109 neonates, 52 stable preterm and 57 healthy term neonates from a nursery of a university medical center. Simultaneous measurements were made at the four sites by three observers. Each infant was studied only once. The highest temperatures were recorded when temperature readings remained unchanged for two minutes. The findings demonstrated that the rectal temperature was significantly higher than the axillary (mean differences of 0.06 and 0.09oC in preterm and term neonates, respectively) and the abdominal skin temperatures (0.3oC in preterm and 0.2oC in term neonates). However, the differences between rectal and axillary temperatures were considered no clinical significance. Tympanic temperatures were significantly higher than the rectal. The mean differences between tympanic and rectal temperatures varied widely depending on the ear side (0.88 and 0.52oC for protected ears, 0.63 and 0.21oC for exposed ears in preterm and term infants, respectively). The temperatures of preterm neonates were not significantly different from the term neonates measured at rectum, axilla, and abdominal skin. Preterm neonates required shorter times to achieve highest temperatures at all sites. There were significant differences in the mean times of axillary and abdominal skin measurements between preterm and term neonates. The mean times of placement in preterm and term neonates, 2.8 and 3.4 minutes for rectum, 5.4 and 7.9 minutes for axilla, and 4.0 and 6.1 minutes for abdominal skin, were considered the optimum times since 91 to 100 per cent of neonates had temperature readings within their highest temperatures - 0.1oC. Conclusion: The axillary temperature is as accurate as rectal temperature measured with mercury- in-glass thermometer if the placement times are optimum. The rectal temperature equals the abdominal skin plus 0.3oC for preterm and plus 0.2oC for term neonates. Temperatures obtained with infrared tympanic thermometer in the rectal equivalent mode do not accurately reflect and is not recommended to substitute for rectal temperatures in neonates.

A Study of Reliability of Tympanic Temperature Measurement Using Infrared Thermometer ( Home Model ) in Neonates

PURPOSE: Taking an accurate and rapid body temperature can give a valuable information when taking care of neonates. The purpose of this study is to compare the reliability of taking rapid and less complicated means of measuring body temperature at tympanic membrane by infrared tympanic thermometer(Thermoscan IRT 1020, type 60005711, home model) with the standard method of taking body temperature at axilla and rectum by mercury thermometer. METHODS: Simultaneous rneasurements of tympanic membrane and axillary temperatures were taken followed by rectal temperatures within 5 minutes by 2 different investigators from 107 term infants One investigator measured tympanic membrane temperature by infrared tyrnpanic thermometer for 3 times and took the highest temperature as a final measurement and the other investigator took the axillary temperature for at least 5 minutes and rectal temperature for at least 2 minutes on each patient. RESULTS: Total of 107 term infants including 57 males and 50 females were subjects, The average body temperatures were 36.7+/-0.3degree, 37.0+/-0.4degree, 36.6+/-0.3degree for axillary, reactal and tympanic membrane, respectively. The correlation coefficients between axillary, rectal and tympanic temperature measurements were high at r=0.746- 0.804 and were statistically significant at P<0.001. CONCLUSION: We have shown from this study that taking tympanic membrane temperature can be used as an altemative and reliable means of taking body temperature in place of taking axillary and rectal temperature in neonates.

A comparative study on thermal insulation effects of blanket and aluminum film / 日本温泉気候物理医学会雑誌

To check the thermal insulation effects of blankets and aluminum film, changes in temperature at the tympanic membrane and at the deep body of the dorsum manus and pedis were measured on healthy adult male subjects. No marked change in temperature was found at the tympanic membrane, implying no influence on the brain temperature. In both the blanket and aluminum film groups, the temperature at the deep body of the dorsum manus and pedis increased significantly, but the temperature increase rate was larger in the aluminum film group than in the blanket group. A particularly significant difference between the two groups was recognized in the temperature at the deep body of the dorsum pedis.<br>The above results revealed that aluminum film had a larger thermal insulation effect and weighed less than a blanket, so aluminum films is more useful than blankets as insulation material.