Abstract
Purpose
To determine the effect of covering the patient’s head and face on the prevention of intraoperative hypothermia (<35.5°C).
Methods
This randomized, prospective trial included 44 adults undergoing elective abdominal surgery. After the induction of anesthesia with thiopental, in 44 patients their extremities and trunk were covered with towels and sheets. In addition, 22 patients (covered group) had their face and head fully covered. Anesthesia was maintained with N2O 50–66 % (2–3 L·min−1) and isoflurane (< IMAC) in oxygen combined with thoracic epidural anesthesia. Core temperature was measured at the tympanic membrane continuously and was recorded at 15 min intervals from the induction of anesthesia. Heat and moisture exchangers were used in their anesthetic circuit. Ambient temperature was maintained near 25°C.
Results
Neither group demonstrated intraoperative hypothermia. However, tympanic membrane temperature at 75, 90, 105 min in the covered group were higherthan those of control group (36.7 ± 0.4°C vs 36.5 ± 0.4°C, 36.8 ± 0.5°C vs 36.4 ± 0.5°C, 36.8 ± 0.5°C vs 36.4 ± 0.5°C, respectively, P < 0.05).
Conclusion
Covering the patient’s head and face maintains intraoperative core temperature.
Résumé
Objectif
Déterminer si le fait de couvrir la tête et le visage des patients contribue à prévenir l’hypothermie peropératoire (<35,5 °C).
Méthode
Lessai randomisé et prospectif a porté sur 44 adultes subissant une intervention abdominale élective. Après l’induction de l’anesthésie avec du thiopental, on a couvert les extrémités et le tronc des 44 patients de serviettes et de draps. De plus, pour 22 d’entre eux (le groupe couvert), on a aussi couvert complètement le visage et la tête. On a maintenu l’anesthésie avec du N2O 50–66 % (2-3 L·min−1) et de l’isoflurane (< ICAM) mêlé à de l’oxygène, combiné à une anesthésie péridurale thoracique. On a procédé à une mesure continue de la température centrale, à la membrane tympanique, et on l’a notée aux 15 min depuis l’induction de l’anesthésie. Les échangeurs de chaleur et d’humidité ont été intégrés au circuit anesthésique. La température ambiante a été maintenue autour de 25 °C.
Résultats
Aucun des patients n’a présenté d’hypothermie peropératoire. Cependant, la température prélevée à la membrane tympanique à 75, 90 et 105 min dans le groupe couvert était plus élevée que dans le groupe témoin (36,7 ± 0,4 °C vs 36,5 ± 0,4 °C, 36,8 ± 0,5 °C vs 36,4 ± 0,5 °C, 36,8 ± 0,5 °C vs 36,4 ± 0,5 °C, respectivement, P < 0,05).
Conclusion
Couvrir la tête et le visage maintient la température centrale peropératoire.
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References
Frank SM, Beattie C, Christopherson R, et al. Unintentional hypothermia is associated with postoperative myocardial ischemia. Anesthesiology 1993; 78: 468–76.
Sheffield CW, Sessler DI, Hunt TK. Mild hypothermia during isoflurane anesthesia decreases resistance toE. coli dermal infection in guinea pigs. Acta Anaesthesiol Scand 1994; 38: 201–5.
Kurz A, Sessler DI, Lenbardt R. Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. New Engl J Med 1996; 334: 1209–15.
Sessler DI, Israel D, Pozos RS, Pozos M, Rubinstein EH. Spontaneous post-anesthetic tremor does not resemble thermoregulatory shivering. Anesthesiology 1988; 68: 843–50.
Schmied H, Kurz A, Sessler DI, Kozek S, Reiter A. Mild hypothermia increases blood loss and transfusion requirements during total hip arthroplasty. Lancet 1996; 347: 289–92.
Heier T, Caldwell JE, Sessler DI, Miller RD. Mild intraoperative hypothermia increases duration of action and spontaneous recovery of vecuronium blockade during nitrous oxide-isoflurane anesthesia in humans. Anesthesiology 1991; 74: 815–9.
Frank SM, Fleisher LA, Breslow MJ, et al. Perioperative maintenance of normothermia reduces the incidence of morbid cardiac events. A randomized clinical trial. JAMA 1997; 277: 1127–34.
Sessler DI, McGuire J, Moayeri A, Hynson J. Isoflurane-induced vasodilation minimally increases cutaneous heat loss. Anesthesiology 1991; 74: 226–32.
Sessler DI, McGuire J, Sessler AM. Perioperative thermal insulation. Anesthesiology 1991; 74: 875–9.
Just B, Trévien V, Delva E, Lienhart A. Prevention of intraoperative hypothermia by preoperative skin-surface warming. Anesthesiology 1993; 79: 214–8.
Hynson JM, Sessler DI, Moayeri A, McGuire J, Schroeder M. The effects of preinduction warming on temperature and blood pressure during propofol/nitrous oxide anesthesia. Anesthesiology 1993; 79: 219–28.
Sessler DI, Schroeder M. Heat loss in humans covered with cotton hospital blankets. Anesth Analg 1993; 77 73–7.
Hynson JM, Sessler DI. Intraoperative warming therapies: a comparison of three devices. J Clin Anesth 1992; 4: 194–9.
Glosten B, Hynson J, Sessler DI, McGuire J. Preanesthetic skin-surface warming reduces redistribution hypothermia caused by epidural block. Anesth Analg 1993; 77: 488–93.
Vassilieff N, Kosenther N, Sessler DI, Conseiller C, Limhart A. Nifedipine and intraoperative core body temperature in humans. Anesthesiology 1994; 80: 123–8.
Shiraki K, Sagawa S, Tajima F, Yokota A, Hashimoto M, Brengelmann GL. Independence of brain and tympanic temperatures in an unanesthetized human. J Appl Physiol 1988; 65: 482–6.
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Kamitani, K., Higuchi, A., Takebayashi, T. et al. Covering the head and face maintains intraoperative core temperature. Can J Anesth 46, 649–652 (1999). https://doi.org/10.1007/BF03013952
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DOI: https://doi.org/10.1007/BF03013952