老年人全麻手术期间中心体温的观察及护理

Observation of the Core Temperature in Elderly Patients Under General Anesthesia

目的探讨老年人全麻手术期间中心体温的变化规律及护理措施。方法选择符合美国麻醉医师协会分级(american society of anesthesiologists,ASA)Ⅰ-Ⅱ级择期行中上腹部手术的老年患者100例。随机分成两组,全麻复合硬膜外组(A组)和单纯全麻组(B组),以食管温度代表中心体温,记录麻醉诱导前(T0)、诱导后10(T10)、30(T30)、60(T60)、90(T90)、120(T120)min及手术结束(Tend)各个时间点的食管温度。结果麻醉诱导后两组的中心体温均有不同程度的下降,A组在诱导30 min后的各个时间点体温下降幅度比B组大,两组比较,差异有统计学意义(P<0.05)。结论老年人全麻复合硬膜外阻滞期间更容易导致低体温,术中应做好保温、保暖护理,以保证老年患者全麻手术期间的安全。

Objective To discuss the changes of core temperature in elderly patients under general anesthesia. Methods One hundred elderly patients undergoing mid-upper abdominal operation were randomly divided into general plus epidural anesthesia group （group A） and general anesthesia group （group B）. The esophageal temperatures were taken as core temperature and were recorded before anesthesia inducement（T0）,and at 10 min （T10）,30 min （T30）, 60 min （T60）, 90 min （T90）, 120 min （T120） after inducement, and at the end of operation （Tend）. Results The core temperatures declined in both groups after anesthetic inducement and the extent of decline in group A was greater than that in group B after T30 （ P 〈0.05）. Conclusion Combination of general and epidural anesthesia in the elderly patients is more liable to cause low body temperature; heat preservation measures should be taken to ensure the safety of the elderly patients during the operation.