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Jong HS, Lim TW, Jung KT. Optimal Insertion Depth of Gastric Decompression Tube with a Thermistor for Patients Undergoing Laparoscopic Surgery in Trendelenburg Position. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14708. [PMID: 36429426 PMCID: PMC9690127 DOI: 10.3390/ijerph192214708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 11/07/2022] [Accepted: 11/08/2022] [Indexed: 06/16/2023]
Abstract
Monitoring core temperature is crucial for maintaining normothermia during general anesthesia. Insertion of a gastric decompression tube (GDT) may be required during laparoscopic surgery. Recently, a newly designed GDT with a thermistor for monitoring esophageal temperature has been introduced. The purpose of the present study was to evaluate the optimal insertion depth of a GDT with a thermistor. Forty-eight patients undergoing elective laparoscopic surgery in the Trendelenburg position were included in the study. The GDT was inserted to a depth of nose-earlobe-xiphoid distance (NEX) + 12 cm and withdrawn sequentially, 2 cm at a time, at 5-min intervals. Temperatures of the GDT thermistor were compared with the core temperature of the tympanic membrane (TM) using Bland and Altman analysis. The correlation between optimal insertion depth of the GDT and anatomical distance (cricoid cartilage to the carina, CCD; carina to the left hemidiaphragm, CLHD) was evaluated, and a mathematical model to predict the optimal insertion depth of the GDT with a thermistor was calculated. Temperatures of TM and GDT thermistor at NEX + 4 cm showed good agreement and strong correlation, but better agreement and stronger correlation were seen at the actual location with the most minor temperature differences. The optimal insertion depth of the GDT was estimated as -15.524 + 0.414 × CCD - 0.145 × CLHD and showed a strong correlation with the actual GDT insertion depth (correlation coefficient 0.797, adjusted R2 = 0.636). The mathematical formula using CCD and CLHD would be helpful in determining the optimal insertion depth of a GDT with a thermistor.
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Affiliation(s)
- Hwa Song Jong
- Department of Anesthesiology and Pain Medicine, Chosun University Hospital, Gwangju 61453, Korea
| | - Tae Won Lim
- Department of Anesthesiology and Pain Medicine, Chosun University Hospital, Gwangju 61453, Korea
| | - Ki Tae Jung
- Department of Anesthesiology and Pain Medicine, Chosun University Hospital, Gwangju 61453, Korea
- Department of Anesthesiology and Pain Medicine, College of Medicine and Medical School, Chosun University, Gwangju 61452, Korea
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EVREN ŞAHİN K, SÖZBİLEN MC. Çocuk Hastanesinde Perioperatif Hipotermi Sıklığı ve Predispozan Faktörler. ACTA MEDICA ALANYA 2022. [DOI: 10.30565/medalanya.1122479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background/Aim: Perioperative hypothermia is more common in pediatric patients than in adult patients due to increased body surface area/weight ratio and limited subcutaneous fat deposits. Therefore, active and passive warming techniques are used more frequently in the surgeries applied to pediatric patients. This study presents the prevalence of perioperative hypothermia and the predisposing conditions for perioperative hypothermia in pediatric orthopedic surgeries in which active and passive warming techniques are applied.
Methods: This cross-sectional, descriptive, and observational study included 102 children admitted to the pediatric orthopedic clinic of a children’s hospital. Temperature measurements were made with a calibrated infrared tympanic thermometer in all cases while they were waiting in the service room, when they entered the operation theater, when they left the operation theater, and when they left the postoperative care unit. Their demographic data, hemogram, and thyroid hormone parameters, preoperative fasting times related to the procedure, and temperature were recorded. Also, the humidity and temperature values of the operating theater, the operation type performed, the anesthesia method applied during the operation, the complications encountered, and the time spent in the operating theater were all recorded in their follow-up forms. Data analysis was done using SPSS V21.0 and was conducted at a 95% confidence interval.
Results: Hypothermia was observed in 20,58% of 102 patients included in the study. Predisposing factors were determined for perioperative hypothermia as follows; the patient's American Society of Anesthesiologists risk score is above 1, concomitant diagnosis of cerebral palsy, low hemoglobin level in the preoperative period, fasting longer than 8 hours, the low body temperature of the patient in the service room, long time stayed in the operating room, and different humidity values of the operating theatre.
Conclusion: Although active and passive warming techniques are applied during the operation, perioperative hypothermia was observed in 20,58% of pediatric patients who underwent the orthopedic operation. Consideration of predisposing factors together with active and passive warming techniques may reduce the incidence of perioperative hypothermia.
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Affiliation(s)
- Kübra EVREN ŞAHİN
- SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, İZMİR DR. BEHÇET UZ ÇOCUK HASTALIKLARI VE CERRAHİSİ SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ
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Yüksek A, Doğan Bakı E, Berrak Sarıtaş T, Sıvacı R. RE: How Are Thermoregulation and Ventilatory Modes Linked? Some Methodological Views. Turk J Anaesthesiol Reanim 2020; 48:349. [PMID: 32864658 PMCID: PMC7434343 DOI: 10.5152/tjar.2020.240420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Ahmet Yüksek
- Department of Anaesthesiology and Reanimation, Afyon Kocatepe University School of Medicine, Afyonkarahisar, Turkey
| | - Elif Doğan Bakı
- Department of Anaesthesiology and Reanimation, Afyon Kocatepe University School of Medicine, Afyonkarahisar, Turkey
| | - Tuba Berrak Sarıtaş
- Department of Anaesthesiology and Reanimation, Afyon Kocatepe University School of Medicine, Afyonkarahisar, Turkey
| | - Remziye Sıvacı
- Department of Anaesthesiology and Reanimation, Afyon Kocatepe University School of Medicine, Afyonkarahisar, Turkey
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Yüksek A, Bakı ED, Sarıtaş TB, Sıvacı R. A Comparison of the Effects of Lung Protective Ventilation and Conventional Ventilation on Thermoregulation During Anaesthesia. Turk J Anaesthesiol Reanim 2018; 47:173-178. [PMID: 31183462 DOI: 10.5152/tjar.2018.73659] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 07/12/2018] [Indexed: 02/06/2023] Open
Abstract
Objective During prolonged surgery, hypothermia is an unwanted condition that frequently develops and increases complication rates. It has been shown that positive end-expiratory pressure (PEEP) during mechanical ventilation reduces hypothermia development by providing earlier peripheral vasoconstriction. In the present study, an investigation was made of the effect of two different ventilation models on perioperative hypothermia development. Methods A total of 40 patients undergoing elective lumbar disc surgery were randomised to either the conventional group (Group C, n=20, tidal volume=10 mL kg-1, PEEP=0 cm H2O) or the lung protective ventilation group (Group P, n=20, tidal volume=6 mL kg-1, PEEP=5 cm H2O). Demographic data on gender, age, weight, height, preoperative-postoperative temperatures and haemodynamic values were recorded. The point where the forearm to fingertip skin temperature difference reached 0°C was determined as the peripheral vasoconstriction development. At this point, the core temperature was recorded as the thermoregulatory vasoconstriction threshold. Results Demographic characteristics of the patients and haemodynamic variables were similar between the groups. Preoperative and postoperative temperature gradients were not significantly different between the two groups (p=0.827). There was also no significant difference between the two groups in respect of the vasoconstriction threshold of the patients (p=0.432). Conclusion The study results showed that lung protective ventilation has no advantage in preserving the perioperative core temperature compared to conventional ventilation.
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Affiliation(s)
- Ahmet Yüksek
- Department of Anaesthesiology and Reanimation, Afyon Kocatepe University School of Medicine, Afyonkarahisar, Turkey
| | - Elif Doğan Bakı
- Department of Anaesthesiology and Reanimation, Afyon Kocatepe University School of Medicine, Afyonkarahisar, Turkey
| | - Tuba Berrak Sarıtaş
- Department of Anaesthesiology and Reanimation, Afyon Kocatepe University School of Medicine, Afyonkarahisar, Turkey
| | - Remziye Sıvacı
- Department of Anaesthesiology and Reanimation, Afyon Kocatepe University School of Medicine, Afyonkarahisar, Turkey
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Seo H, Do Son J, Lee HC, Oh HM, Jung CW, Park HP. Effects of positive end-expiratory pressure on intraoperative core temperature in patients undergoing posterior spine surgery: prospective randomised trial. J Int Med Res 2017; 46:984-995. [PMID: 29119875 PMCID: PMC5972243 DOI: 10.1177/0300060517734678] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective Positive end-expiratory pressure (PEEP) causes carotid baroreceptor unloading, which leads to thermoregulatory peripheral vasoconstriction. However, the effects of PEEP on intraoperative thermoregulation in the prone position remain unknown. Methods Thirty-seven patients undergoing spine surgery in the prone position were assigned at random to receive either 10 cmH2O PEEP (Group P) or no PEEP (Group Z). The primary endpoint was core temperature 180 minutes after intubation. Secondary endpoints were delta core temperature (difference in core temperature between 180 minutes and immediately after tracheal intubation), incidence of intraoperative hypothermia (core temperature of <36°C), and peripheral vasoconstriction-related data. Results The median [interquartile range] core temperature 180 minutes after intubation was 36.1°C [35.9°C-36.2°C] and 36.0°C [35.9°C-36.4°C] in Groups Z and P, respectively. The delta core temperature and incidences of intraoperative hypothermia and peripheral vasoconstriction were not significantly different between the two groups. The peripheral vasoconstriction threshold (36.2°C±0.5°C vs. 36.7°C±0.6°C) was lower and the onset of peripheral vasoconstriction (66 [60-129] vs. 38 [28-70] minutes) was slower in Group Z than in Group P. Conclusions Intraoperative PEEP did not reduce the core temperature decrease in the prone position, although it resulted in an earlier onset and higher threshold of peripheral vasoconstriction.
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Affiliation(s)
- Hyungseok Seo
- 1 Department of Anaesthesiology and Pain Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea
| | - Je Do Son
- 2 Department of Anaesthesiology and Pain Medicine, Keimyung University Dongsan Hospital, Keimyung University College of Medicine, Daegu, Korea
| | - Hyung-Chul Lee
- 3 Department of Anaesthesiology and Pain Medicine, 58927 Seoul National University Hospital , Seoul National University College of Medicine, Seoul, Korea
| | - Hyung-Min Oh
- 3 Department of Anaesthesiology and Pain Medicine, 58927 Seoul National University Hospital , Seoul National University College of Medicine, Seoul, Korea
| | - Chul-Woo Jung
- 3 Department of Anaesthesiology and Pain Medicine, 58927 Seoul National University Hospital , Seoul National University College of Medicine, Seoul, Korea
| | - Hee-Pyoung Park
- 3 Department of Anaesthesiology and Pain Medicine, 58927 Seoul National University Hospital , Seoul National University College of Medicine, Seoul, Korea
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Lim SH, Lee W, Park J, Kim MH, Cho K, Lee JH, Cheong SH, Lee KM. Preoperative interscalene brachial plexus block aids in perioperative temperature management during arthroscopic shoulder surgery. Korean J Anesthesiol 2016; 69:362-7. [PMID: 27482313 PMCID: PMC4967631 DOI: 10.4097/kjae.2016.69.4.362] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 04/22/2016] [Accepted: 04/22/2016] [Indexed: 11/22/2022] Open
Abstract
Background Hypothermia is common during arthroscopic shoulder surgery under general anesthesia, and anesthetic-impaired thermoregulation is thought to be the major cause of hypothermia. This prospective, randomized, double-blind study was designed to compare perioperative temperature during arthroscopic shoulder surgery with interscalene brachial plexus block (IBPB) followed by general anesthesia vs. general anesthesia alone. Methods Patients scheduled for arthroscopic shoulder surgery were randomly allocated to receive IBPB followed by general anesthesia (group GB, n = 20) or general anesthesia alone (group GO, n = 20), and intraoperative and postoperative body temperatures were measured. Results The initial body temperatures were 36.5 ± 0.3℃ vs. 36.4 ± 0.4℃ in group GB vs. GO, respectively (P = 0.215). The body temperature at 120 minutes after induction of anesthesia was significantly higher in group GB than in group GO (35.8 ± 0.3℃ vs. 34.9 ± 0.3℃; P < 0.001). The body temperatures at 60 minutes after admission to the post-anesthesia care unit were 35.8 ± 0.3℃ vs. 35.2 ± 0.2℃ in group GB vs. GO, respectively (P < 0.001). The concentrations of desflurane at 0, 15, and 120 minutes after induction of anesthesia were 6.0 vs. 6.0% (P = 0.330), 5.0 ± 0.8% vs. 5.8 ± 0.4% (P = 0.001), and 3.4 ± 0.4% vs. 7.1 ± 0.9% (P < 0.001) in group GB vs. GO, respectively. Conclusions The present study demonstrated that preoperative IBPB could reduce both the intraoperative concentration of desflurane and the reduction in body temperature during and after arthroscopic shoulder surgery.
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Affiliation(s)
- Se Hun Lim
- Department of Anesthesiology and Pain Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Wonjin Lee
- Department of Anesthesiology and Pain Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - JaeGwan Park
- Department of Anesthesiology and Pain Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Myoung-Hun Kim
- Department of Anesthesiology and Pain Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Kwangrae Cho
- Department of Anesthesiology and Pain Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Jeong Han Lee
- Department of Anesthesiology and Pain Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Soon Ho Cheong
- Department of Anesthesiology and Pain Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Kun Moo Lee
- Department of Anesthesiology and Pain Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
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