İntrakraniyal kitle cerrahisinde preoperatif dönemdeki ısıtmanın hipotermiyi önlemedeki etkisi

Year 2023, , 678 - 684, 30.12.2023

Merve Sevim Artykov , Nihal Gökbulut Özaslan

https://doi.org/10.18663/tjcl.1320778

Abstract

Amaç: Perioperatif hipotermi anestezi uygulaması sırasında sık karşılaşılan bir sorundur. Amacımız intrakraniyal kitle cerrahisinde hipoterminin hasta üzerindeki olumsuz etkilerini önlemek için preoperatif dönemden başlayarak ısıtmanın etkilerini araştırmaktır.
Gereç ve Yöntemler: Prospektif, randomize olarak intrakraniyal kitle cerrahisi geçiren hastalar iki gruba ayrıldı. Çalışma grubu aktif ısıtma cihazıyla operasyon öncesi ısıtıldı. Kontrol grubuna ise yalnızca pike örtüldü. Her iki grup da intraoperatif dönemde ısıtıldı. 15 dakikada bir vital bulgular (standart monitörizasyona ek olarak invaziv arteriyel kan basıncı),30 dakikada bir vücut sıcaklığı, saatlik olarak arter kan gazından laktat bakıldı. Titreme skorları, toplam anestezi ve operasyon süresi, tüketilen ilaç miktarları, iv mayi ve kanama miktarı not edildi.
Bulgular: Her grupta 36’şar olmak üzere toplam 72 hasta değerlendirildi. Gruplar arasında demografik ve klinik özellikler açısından anlamlı fark yoktu. Gruplar arasında cerrahinin 15-255. dakikaları arasında ölçülen ısı değerleri arasında anlamlı fark bulundu (p<0,05). Ön ısıtma yapılmayan hastaların tümünde en az bir defa hipotermik vücut sıcaklık değeri vardı. Önceden ısıtılan grupta ise yalnızca %11,1 hastada hipotermi saptandı.
Sonuç: İntrakraniyal kitle cerrahisi geçirecek hastalarda aktif eksternal ısıtıcı sistemler ile intraoperatif ve postoperatif dönemde hipoterminin önlenebileceği tespit edilmiştir.

Keywords

hipotermi, preoperatif ısıtma, sıcak hava üflemeli ısıtma sistemleri, intrakraniyal kitle cerrahisi

Supporting Institution

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Thanks

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The efficacy of preoperative warming at prevention of involuntary hypothermia in patients undergoing surgery for intracranial mass lesions

Abstract

Aim: Perioperative hypothermia is a common problem during anesthesia procedure. In this study we aimed to determine if preoperative warming was effective at preventing involuntary hypothermia in patients undergoing neurosurgery for intracranial mass.
Material and Methods: Patients undergoing surgery for intracranial mass lesions were prospectively and randomly assigned into two groups. The study group was warmed up before the operation with an active warming device. In the control group, only the blanket was covered. Both groups were warmed intraoperatively. Vital signs (invasive arterial blood pressure in addition to standard monitoring), body temperature every 30 minutes, and lactate from arterial blood gas hourly were measured every 15 minutes. Shivering scores, total anesthesia and operation time, amount of drug consumed, amount of iv fluid and bleeding were noted.
Results: A total of 72 patients were included and divided into two groups of 36 patients each. There was no significant difference in terms of demographics and clinical characteristics between the groups. There was a statistically significant difference between the groups in terms of the temperature values during the period between 15–255 minutes of surgery. There was statistically significant difference between the groups in terms of inadvertent hypothermia incidence (p<0.05). At least one hypothermic measurement was spotted in all of control patients. Only %11.1 of patients in pre-warmed group had hypothermic temperature incidence.
Conclusion: Active pre-warming with body surface warming systems is effective at preventing of inadvertent hypothermia in patients undergoing intracranial surgery for mass lesions.

Keywords

hypothermia, preoperative warming, active body surface warming systems, brain neoplasms

Project Number

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