Comparison the Effects of Different Temperatures on the Core Temperature and the Concentrations of Lactate in Patients Who Were Candidate for Posterior Spine Fusion Surgery Under General Intravenous Anesthesia
Background: Long surgery causes hypothermia and increased bleeding and can increase the arterial blood lactate levels during anesthesia. It causes cellular hypoxia and its complications. Considering the core temperature of the patient during surgery it can prevent hypoxia. This study aimed to compare the effects of different temperatures on the core temperature and the concentrations of lactate in patients who were candidate for posterior spine fusion surgery under general intravenous anesthesia.
Methods: In this clinical trial study, 60 patients with ASA II risk undergoing spine fusion surgery referred to Rasoul Akram hospital from 2015 were studied. Patients were divided in two groups of receiving temperature of 36 ° and 40 ° C during operation. Demographic data as well as information before anesthesia, after surgery, as well as recovery was gathered in the check list. Data then were entered to the statistical software SPSS v. 16 and analyzed.
Results: The mean age of patients was 49.14 (SD= 12.97) years. Pre-operation O2 Saturation had significant difference between the two groups (p value = 0.015). Trend of Hb, HCT, HR, SBP, O2 Sat, operating room temperature, pH, arterial HCO3, arterial O2 pressure, arterial blood lactate, degree of arterial blood saturation and arterial access base in 36ºC group (p value <0.05). Trend of Hb, HCT, HR, SBP, O2 Sat, operating room temperature, pH, HCO3 level of arterial pressure, arterial O2, arterial CO2 pressure, degree of saturation of arterial blood and arterial access was statistically significant in 40ºC group (p value <0.05).
Conclusion: In bleeding and low blood pressure and hypothermia, the level of serum lactate is more than 3.5 meq/L, which is caused by cellular hypoxia. In our study in two temperatures during operation lactate level was low because of longer time of operation that shows loss of hypoxia and high level of consciousness and less complication. Also time of waking up was more rapid. So as lactate level was low, prophylaxis of hypoxia is more.
M Giuffre, T Heidenreich, L Pruitt. Rewarming Cardiac Surgery Patients: Radiant Heat Versus Forced Warm Air. Nurs Res. 1994; 43(3): 174-8.
Danczuk RD, Nascimento ER, Hermida PM, Hagemann LB, Bertoncello KC, Jung W. TYMPANIC AND TEMPORAL THERMOMETRY IN HYPOTHERMIA ASSESSMENT FOR ADULT IN INTRAOPERATIVE ABDOMINAL SURGERY. Texto Contexto Enferm, 2016; 25(4):e7210015.
Ziganshin BA, Elefteriades JA. Deep hypothermic circulatory arrest. Annals of Cardiothoracic Surgery. 2013; 2(3):303-15.
Heidenreich T, Giuffre M, Doorley J. Temprerure and tempreture measurement after induced hypothermia. Nurs Res. 1992; 41(5):296-300.
Carli F, Webster J, Nandi P, MacDonald IA, Pearson J, Mehta R. Thermogenesis after surgery: Effect of perioperative heat conservation and epidural anesthesia. Am J Physiol. 1992; 263(3 Pt 1): E441-7.
Frank SM, Higgins MS, Breslow MJ, Fleisher LA, Gorman RB, Sitzmann JW, et al. The catecholamine, cortisol, and hemodynamic responses to mild perioperative hypothermia. A randomized clinical trial. Anesthesiology. 1995; 82(1):83-93.
Frank SM, Beattie C, Christopherson R, Norris EJ, Perler BA, Williams G, et al. Unintentional hypothermia is associated with postoperative myocardial ischemia. The Perioperative Ischemia Randomized Anesthesia Trial Study Group. Anesthesiology. 1993; 78(3):468-76.
Van Oss CJ, Absolom DR, Moore LL, Park BH, Humbert JR. Effect of temperature on the chemotaxis, phagocytic engulfment, digestion and O2 consumption of human polymorphonuclear leukocytes. J Reticuloendothelial Soc. 1980; 27(6):561-5.
Kurz A, Sessler DI, Lenhardt R. Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. N Engl J Med. 1996; 334:1209-16.
Carli F, Webster J, Pearson M, Forrest J, Venkatesan S, Wenham D, et al. Postoperative protein metabolism: Effect of nursing elderly patients for 24 h after abdominal surgery in a thermoneutral environment. Br J Anaesth. 1991; 66(3):292-9.
Kehlet H. The stress response to surgery: Release mechanisms and the modifying effect of pain relief. Acta Chir Scand Suppl. 1989; 550:22-8.
Bonica JJ, Berges PU, Morikawa K. Circulatory effects of peridural block: Effects of level of analgesia and dose of lidocaine. Anesthesiology. 1970; 33(6):619-26.
Glosten B, Sessler DI, Faure EA, Karl L, Thisted RA. Central temperature changes are poorly perceived during epidural anesthesia. Anesthesiology. 1992; 77(1):10-6.
Carli F, Kulkarni P, Webster JD, MacDonald IA. Post-surgery epidural blockade with local anaesthetics attenuates the catecholamine and thermogenic response to perioperative hypothermia. Acta Anaesthesiol Scand. 1995; 39(8):1041-7.
Sessler DI. Complications and Treatment of Mild Hypothermia. Anesthesiology. 2001; 95(2): 531-43.
Howel RD, MacRae LD, Sanjines S, Burke J, DeStefano P. Effect of two types of head coverings in the rewarming of patients after coronary artery bypass graft surgery. Heart lung. 1992; 21 (1): 1-5.
Ramachandra V, Moore C, Kaur N, Carli F. A study into the effect of halothane, enflurane and isoflurane on perioperative body tempreture. Br J Anaesth. 1989; 62(4): 409-14.
Itoh T, Thomas R, Foltz BD, Dillard DH. Blood anesthetic levels during surface-induced deep hypothermia under halothane-diethyl ether azeotrope anesthesia. Tohoku J Exp Med. 1986; 148(1):103-11.
Burton GW. Metabolic acidosis during profound hypothermia. Anaesthesia. 1964; 19:365-75.
Carson SA, Morris LE. Controlled acidbase status with cardiopulmonary bypass and hypothermia. Anesthesiology. 1962; 23: 618-626.
Neligan PJ, Deutschman CS. Perioperative acid-base balance. Miller’s anesthesia. 6th ed. Philadelphia: Elsevier. 2005:1599-615.
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