Effect of multimodal warming regimen on development of intraoperative hypothermia in patients undergoing precise hepatectomy / 中华麻醉学杂志

ABSTRACT

Objective To evaluate the effect of multimodal warming regimen on the development of intraoperative hypothermia in the patients undergoing precise hepatectomy.Methods Sixty patients of both sexes,aged 28-64 yr,weighing 44-89 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ (Child-Pugh A),undergoing precise hepatectomy,were equally and randomly assigned into control group (group C) and muhi-model warming group (group M) using a random number table.A bed sheet was covered on the body exposed,and the abdominal cavity was washed using the room-temperature peritoneal layage fluid in group C.In group M,after admission to the operating room,the room temperature was raised to 25-26 ℃,the mattress was prewarmed using the medical heating blanket,the temperature was maintained at 40 ℃ during operation,the lower body was simultaneously covered using the forced-air warming system,and the temperature was maintained at 37-39 ℃;the solution used for infusion was warmed to 37 ℃ before anesthesia;the incisional area was washed with 0.9％ sodium chloride injection which was prewarmed to 37 ℃ during operation.The development of hypothermia,hypotension and respiratory depression was recorded during operation.Before induction of anesthesia,at 1 h after anesthesia,at the end of operation,and at 5 min before discharge from postanesthesia care unit (PACU),blood gas analysis was performed,and the pH value,base excess and lactate level were recorded.The intraoperative blood loss,emergence time,duration of PACU stay,and occurrence of shivering,agitation,nausea and vomiting were also recorded.Results Compared with group C,the incidence of intraoperative hypothermia,and shivering,agitation,nausea and vomiting in PACU were significantly decreased,the emergence time and duration of PACU stay were significantly shortened,the pH value was significantly increased at 5 min before discharge from PACU,and the base excess and lactate level were significantly decreased at the end of operation and 5 min before discharge from PACU in group M (P＜0.05 or 0.01).Conclusion Multimodal warming regimen can raise the quality of recovery from anesthesia and decrease the development of intraoperative hypothermia in the patients undergoing precise hepatectomy.