Comparison Of The Effect Of Propofol And Sevoflurane On Thermoregulation In Toddlers Undergoing DDH Surgery

Objective:To compare the effect of propofol and sevoflurane on hermoregulat ion in toddlers undergoing orthopaedic surgery. Aimed to investigate which of the ahesthetics resulted in better preservation of thermoregulation in toddlers undergoing orthopaedic surgery.Methods:The study had applied randomized single-blind controlled design. Seventy toddlers were randomly allocated to receive propofol(group P) or sevoflurane( group S) anesthesia, 35 cases in each group. They were dated surgery in September 2014 to April 2015, aged 1 to 3, weighting in 9 to 15 kg and scheduling to undergo orthopaedic surgery in general anesthesia. Group P induced with propofol(2~3mg/kg) and maintained with propofol(6~9mg·kg-1·h-1) and Group S induced with sevoflurane(6%-8%) and maintained with sevoflurane(2%-3%). Tympanic temperature, nasopharyngeal temperature, the heart rate, the blood pressure and SpO2 were recorded 5 minutes before(T0) and after(T1) induction of anesthesia and every 15 minutes after induction of anesthesia(T2、T3、T4、T5、T6、T7、T8、T9). Anaesthetic usage, infusion volume, bleeding, hypothermia and shivering were recorded in surgery. Otherwise, the duration of anesthesia, the duration of surgery, the extubation time, WBC after surgery, HGB, hospital costs and hospitalization days were also noted.Results:Data of 68 patients were taken into analysis; 2 patients was excluded, one for each group. The difference of the general information, the temperature in the operating room, infusion volume, the duration of surgery and anesthesia had no statistical significance in both groups of toddlers. There was also no statistical significance in the difference of SpO2 HR MAP and the anesthetics dosage in both groups of toddlers in surgery. During the surgery, temperature of both groups showed the same changes(P<0.05). Their body temperature declined at first, and then increased. Nasopharyngeal temperature was lower than tympanic temperature(P<0.05) after induction of anesthesia, and both of the change trend was the same(Group P: r=0.866,P<0.05; Group S: r=0.931,P<0.05). In both groups of toddlers undergoing surgery, tympanic temperature was affected differently when giving different anesthetics(P<0.05). Compared with group P, toddlers in group S had lower tympanic temperature,which had statistical significance at T7 and T8(P<0.05). Compared with group P, toddlers in group S had a higher incidence of hypothermia(P<0.05). The toddlers’ lowest tympanic temperature of group S was lower than group P as well(P<0.05). Toddlers both in group S and group P had no incidence of shivering after surgery. Toddlers in group S had longer hospitalization days(P<0.05). There had no statistical significance in other aspects.Conclusion:The research shows that the body temperature declines at first then increased in toddlers undergoing orthopaedic surgery. Compared with propofol, sevoflurane is more likely to lead to the incidence of hypothermia in toddlers undergoing orthopaedic surgery. Propofol can provide more stable thermoregulation in toddlers undergoing orthopaedic surgery. Tympanic temperature is higher than nasopharyngeal temperature. Infrared tympanic thermometer has a high accuracy, which can measure accurate core body temperature for toddlers in poor cooperation degree before surgery.