RESUMO
PURPOSE: Compare perioperative temperature management between forced-air warming (FAW) and resistive-polymer heating blankets (RHBs). DESIGN: A retrospective, quasi-experimental study. METHODS: Retrospective data analysis of nonspine orthopedic cases (N = 426) over a one-year period including FAW (n = 119) and RHBs (n = 307). FINDINGS: FAW was associated with a significantly higher final intraoperative temperature (P = .001, d = 0.46) than the RHB. The incidence of hypothermia was not found to be significantly different at the end (P = .102) or anytime throughout surgery (P = .270). Of all patients who started hypothermic, the FAW group had a lower incidence of hypothermia at the end of surgery (P = .023). CONCLUSIONS: FAW was associated with higher final temperatures and a greater number of normothermic patients than RHBs. However, no causal relationship between a warming device and hypothermia incidence should be assumed.
Assuntos
Ar Condicionado/instrumentação , Calefação/instrumentação , Hipotermia/prevenção & controle , Adulto , Idoso , Idoso de 80 Anos ou mais , Ar Condicionado/métodos , Ar Condicionado/estatística & dados numéricos , Regulação da Temperatura Corporal/fisiologia , Feminino , Calefação/normas , Calefação/estatística & dados numéricos , Humanos , Hipotermia/terapia , Complicações Intraoperatórias/prevenção & controle , Masculino , Pessoa de Meia-Idade , Período Perioperatório , Polímeros/administração & dosagem , Polímeros/uso terapêutico , Estudos Retrospectivos , Estatísticas não ParamétricasRESUMO
Postoperative nausea and vomiting (PONV) continue to be among the most undesirable and distressing complications following general anesthesia, affecting 20% to 30% of all surgical patients and up to 70% of patients with multiple known risk factors. The purpose of this study was to reexamine the effectiveness of metoclopramide in the prevention of PONV when stratified by PONV risk scores. Secondary data from 2,116 adult ambulatory surgical patients were analyzed. Participants were, on average (SD), 49.7 (15.4) years of age, with a mean body mass index of 28.3 (6.9) kg/m², and were primarily female (65%). Risk scores for PONV ranged from 0 to 4, with a mean of 2.6 (1.0). Metoclopramide, 10 mg intravenously (IV) alone; metoclopramide, 10 mg IV, combined with ondansetron, 4 mg IV; and metoclopramide, 10 mg IV, combined with dexamethasone, 8 mg IV, and ondansetron, 4 mg IV, had a beneficial effect for adult ambulatory surgical patients with PONV risk scores of 1 to 4. Although this cohort study had limitations, future studies should investigate metoclopramide based on risk score recommendations, and guidelines should be reevaluated.
