Induction techniques that reduce redistribution hypothermia: a prospective, randomized, controlled, single blind effectiveness study

BMC Anesthesiology

Jonathan V. Roth¹  Lacy H. Hunt²  Leonard E. Braitman² 

[1] Department of Anesthesiology, Albert Einstein Medical Center, 5501 Old York Road, Philadelphia, PA, USA;Albert Einstein Healthcare Network, Philadelphia, PA, USA;Sidney Kimmel Medical School of Thomas Jefferson University, Philadelphia, PA, USA;Office for Research and Technology Development, Albert Einstein Medical Center, 5501 Old York Road, Philadelphia, PA, USA;

关键词: Hypothermia;    Redistribution hypothermia;    Intraoperative hypothermia;    Perioperative hypothermia;    Postoperative hypothermia;    Anesthesia induction;    Inhalation induction;    Intravenous induction;    Inhalation anesthesia induction;    Intravenous anesthesia induction;   

DOI  :  10.1186/s12871-019-0866-8

来源: Springer

【 摘 要 】

BackgroundWhile much effort has been devoted to correcting intraoperative hypothermia, less attention has been directed to preventing redistribution hypothermia. In this study, we compared three different anesthetic induction techniques to standard IV propofol inductions (control) in their effect on reducing redistribution hypothermia.MethodsElective, afebrile patients, age 18 to 55 years, were randomly assigned to one of four groups (n = 50 each). Group “INH/100” was induced with 8% sevoflurane in 100% oxygen, Group “INH/50” with 8% sevoflurane in 50% oxygen and 50% nitrous oxide, Group “PROP” with 2.2 mg/kg propofol, and Group “Phnl/PROP” with 2.2 mg/kg propofol immediately preceded by 160 mcg phenylephrine. Patients were maintained with sevoflurane in 50% nitrous oxide and 50% oxygen in addition to opioid narcotic. Forced air warming was used. Core temperatures were recorded every 15 min after induction for 1 h.ResultsCompared to control group PROP, the mean temperatures in groups INH/100, INH/50, and Phnl/PROP were higher 15, 30, 45 and 60 min after induction (p < 0.001 for all comparisons), averaging between 0.39 °C and 0.54 °C higher. In group PROP, 60% of patients had at least one temperature below 36.0 °C in the first hour whereas only 16% did in each of groups INH/100, INH/50, and Phnl/PROP (p < 0.0001 in each group compared to PROP).ConclusionsIn this effectiveness trial, inhalation inductions with sevoflurane or with prophylactic phenylephrine bolus prior to propofol induction reduced the magnitude of redistribution hypothermia by an average of 0.4 to 0.5 °C in patients aged 18 to 55 years.Trial registrationRetrospectively registered on clinical-trials.gov as NCT02331108, November 20, 2014.

【 授权许可】

CC BY