麻醉方式对食管手术患者围术期体温的影响

Effect of anesthesia methods on perioperative body temperature in patients undergoing operation for esophagus cancer

目的探讨麻醉方式对体温的影响。方法择期经三切口食管癌根治手术患者80例,随机分为硬膜外复合全身麻醉组（A组,n=42）和单纯全身麻醉组（B组,n=38）,麻醉诱导后3 h内每30分钟记录鼻咽温与末梢皮温。3 h后采取变温毯和输液加温等综合方法进行复温,记录复温1 h后的鼻咽温上升幅度及术毕在麻醉苏醒室内寒颤的发生率。结果两组皮温均缓慢下降。鼻咽温第1小时内为快速下降相;1-3 h为缓慢下降相,缓慢下降相时A组下降幅度比B组大（P〈0.05）。A组苏醒期寒颤发生率高于B组（P〈0.05）。结论食管癌根治术采用硬膜外复合全身麻醉比单纯全身麻醉更容易出现围术期低温。

Objective To investigate the effect of different anesthesia methods on perioperative body temperature.Methods Eighty patients undergoing esophagus cancer resection were randomized into two groups of combined general and epidural anesthesia（GEA,group A,42 cases） and general anesthesia（GA,group B,38 cases）.Epipharynx and peripheral temperatures were recorded at the same time every 30 minutes for 3 hours after induction.Epipharynx temperature was recorded than after when circulating water mattresses and fluid warming were used to rewarming.The incidence of postoperative shivering was recorded.Results The peripheral temperature was gradually decreased after induction in both groups.The core temperature was decreased quickly within the first 1 hour in both groups,which was reduced slowly within the next two hours with a greater magnitude of temperature reduction in group A than that in group B（P〈0.05）.The incidence of shivering was higher in group A than that in group B during warming up.Conclusion The patients undergoing long procedures such as esophagus cancer recection under GEA is at more risk for hypothermia than those under GA.