Estudo comparativo na prevenção da hipotermia no transoperatório: manta versus colchão térmico
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Data
2012-02-29
Autores
Moysés, Ariane Marques [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
Comparar a eficiência dos dispositivos manta e colchão térmicos na manutenção da normotermia em pacientes nos períodos intra e pósoperatório; Analisar o período de tempo da recuperação pós-anestésica, com o uso dos dispositivos manta e colchão térmicos; relacionar a utilização dos dispositivos manta e colchão térmicos às variáveis: idade, índice de massa corpórea (IMC) e porte cirúrgico. Trata-se de estudo transversal, prospectivo, randomizado, de delineamento quantitativo, realizado na unidade de Centro Cirúrgico do Hospital das Clínicas de Botucatu, de janeiro a outubro de 2011. Participaram da pesquisa 38 pacientes que foram divididos em 2 grupos (G1 e G2), sendo ambos compostos por 19 pacientes. G1 utilizou a manta térmica com sistema de aquecimento Bair Hugger® modelo 750, sendo esta posicionada nos membros inferiores. G2 utilizou o colchão térmico com circulação de ar quente KanMedo WarmCloudTM. Inicialmente o colchão foi posicionado sobre a mesa cirúrgica a uma temperatura 37oC e insuflado, em seguida os pacientes foram posicionados em decúbito dorsal horizontal, em contato direto com o colchão. Para a coleta dos dados utilizou-se instrumento confeccionado pelo pesquisador, composto por 4 itens: caracterização do paciente, fatores relacionados ao procedimento cirúrgico, aspectos relacionados à recuperação pós-anestésica e tempo de internação. O tempo cirúrgico foi maior no grupo G2 (p=0,03), porém, não se observou aumento na incidência de hipotermia neste grupo; no G2 evidenciou-se uma tendência a menor tempo de recuperação pós-anestésica (p=0,06). A infusão de amido no intraoperatório do G2 foi maior (p=0,03), porém, não influenciou na ocorrência de hipotermia. No G2 a temperatura axilar foi maior aos 120 minutos do inicio do procedimento anestésico cirúrgico...
surgical outcomes, and increased patient satisfaction. The use of perioperative forced-air warming devices is one way of preventing inadvertent hypothermia. There is scant evidence, however, on the best warming method or the acceptability of these methods to patients. The present study aimed to compare two forced-air warming devices to maintain perioperative normothermia: blanket versus mattress. Information was obtained from 38 patients underwent gastrointestinal surgical procedures. Skin and esophageal temperatures were compared for patients who were warmed with a warming blanket (Bair Hugger®), placed over the lower extremities (G1), versus patients who were warmed with a warming mattress (KanMedo WarmCloudTM) placed under the patient’s body (G2). In addition to the temperature evaluation, length of the surgical procedure, total volume of intraoperative fluid replacement, and length of stay in the Post Anesthetic Care Unit (PACU) were also recorded. Although the length of surgery was longer in G2 (291.6±115.2 versus 214.6±91.1 minutes; p=0.03), there was no increase in the hypothermia incidence in this group. Skin temperature was higher at 120 minutes after anesthesia induction in G2 (35.3±0.9 versus 34.8±0.8; p=0.04). Esophageal temperature was also higher in G2 at 120 and at 180 minutes after anesthesia induction, as well as, at the end of the surgery (36.1±0.7 versus 35.4±0.6, p <0.001; 35.9±0.7 versus 35.3±0.7, p=0.03; and 36.1±0.7 versus 35.2±0.9, p<0.001 respectively). Although the patients in G2 had 30 minutes shorter length of stay in the PACU, there was no statistically significant difference between the two groups (115.4±47.3 versus 82.5±53.1 minutes; p=0.06). The infused volume of Hetarstarch was higher in G2 when compared with G1 (730.8±259.4 versus 541.7±144.3; p=0.03)... (Complete abstract click electronic access below)
surgical outcomes, and increased patient satisfaction. The use of perioperative forced-air warming devices is one way of preventing inadvertent hypothermia. There is scant evidence, however, on the best warming method or the acceptability of these methods to patients. The present study aimed to compare two forced-air warming devices to maintain perioperative normothermia: blanket versus mattress. Information was obtained from 38 patients underwent gastrointestinal surgical procedures. Skin and esophageal temperatures were compared for patients who were warmed with a warming blanket (Bair Hugger®), placed over the lower extremities (G1), versus patients who were warmed with a warming mattress (KanMedo WarmCloudTM) placed under the patient’s body (G2). In addition to the temperature evaluation, length of the surgical procedure, total volume of intraoperative fluid replacement, and length of stay in the Post Anesthetic Care Unit (PACU) were also recorded. Although the length of surgery was longer in G2 (291.6±115.2 versus 214.6±91.1 minutes; p=0.03), there was no increase in the hypothermia incidence in this group. Skin temperature was higher at 120 minutes after anesthesia induction in G2 (35.3±0.9 versus 34.8±0.8; p=0.04). Esophageal temperature was also higher in G2 at 120 and at 180 minutes after anesthesia induction, as well as, at the end of the surgery (36.1±0.7 versus 35.4±0.6, p <0.001; 35.9±0.7 versus 35.3±0.7, p=0.03; and 36.1±0.7 versus 35.2±0.9, p<0.001 respectively). Although the patients in G2 had 30 minutes shorter length of stay in the PACU, there was no statistically significant difference between the two groups (115.4±47.3 versus 82.5±53.1 minutes; p=0.06). The infused volume of Hetarstarch was higher in G2 when compared with G1 (730.8±259.4 versus 541.7±144.3; p=0.03)... (Complete abstract click electronic access below)
Descrição
Palavras-chave
Corpo - Temperatura - Regulação, Hipotermia, Tratamento cirurgico, Body temperature - Regulation
Como citar
MOYSÉS, Ariane Marques. Estudo comparativo na prevenção da hipotermia no transoperatório: manta versus colchão térmico. 2012. 67 f. Dissertação (mestrado) - Universidade Estadual Paulista Julio de Mesquita Filho, Faculdade de Medicina de Botucatu, 2012.