| Objective:To compare the change of core temperature,the occurrence of shivering and the thermal comfort of the parturients,to explore the application effect of forced air-prewarming in the parturients after cesarean section,so as to provide a basis for the protection of the body temperature of the parturients.Methods:90 parturients who underwent cesarean section were randomly divided into group A(passive insulation group),group B(air-warming for lower extremity)and group C(forced air-prewarming),with 30 cases in each group.The parturients in group A received conventional laying and single insulation.In group B,the parturients were firstly treated with conventional single heat preservation,and the lower limbs were inflated and heated at the beginning of the operation.In group C,the parturients were forced air-prewarming before the beginning of anesthesia for 20 min,and then replaced with conventional heat preservation.Group B and Group C were heated by inflatable temperature riser combined with disposable inflatable insulation blanket,and the temperature was set at 38℃.The tympanic temperature was measured in the ipsilateral ear of the parturients from entered the operating room until left the PACU(postanesthesia care unit).Recorded and compared the changes of core temperature in three groups including parturients entered the operating room(T0),before the beginning of anesthesia(T1),10min(T2),20min(T3),30min(T4),40min(T5),at the end of surgery(T6),after entering PACU for 10min(T7),20min(T8)and 30min(T9),incidence of shivering at different time points,intraoperative blood pressure and heart rate.Also recorded the thermal comfort score at T1,T4,T6 and T9,perioperative hypothermia and the incidence of nausea and vomiting.The Wrench classification standard was adopted for the shivering classification,and the thermal comfort was evaluated by the scale method.Results:(1)The core temperature of the three groups was compared at different time points.At T1 and T2,the core temperature of group C was higher than that of group A and group B,with statistical significance(P < 0.05).During T3～T9,compared with group A,the core temperature of groups B and C was higher,and that of group C was higher than group B,with statistical significance(P < 0.05),indicating that group C had the best thermal insulation effect.(2)The changes of core temperature of the three groups were compared.From T0 to T6,the core temperature of the three groups showed A decreasing trend,the decreasing range of group B and C was smaller than that of group A,and the decreasing range of group C was the least,with statistical significance(P < 0.05).From T6 to T9,the core temperature of the three groups showed an upward trend.Compared with group A and B,the upward trend of group C was smaller,with statistical significance(P < 0.05).Overall comparison between T0 and T9 showed A downward trend in the core temperature of the three groups.The decreasing amplitude of group B and C was smaller than that of group A,and the decreasing amplitude of group C was the smallest,which was statistically significant(P < 0.05),indicating that group C could effectively slow down the decreasing amplitude of the maternal core temperature and was conducive to maintaining the stability of the maternal core temperature.(3)The incidence of chills in the three groups at different time points was compared,and the incidence of chills in group C was significantly lower than that in group A and B at T5 and T6,with statistical significance(P < 0.05).At T4 and T7,compared with groups A and B,no shivering occurred in group C,which was statistically significant(P < 0.05).Compared with the total incidence of shivering,the incidence of shivering in group C was lower than that in group A and B,which was statistically significant(P< 0.05),indicating that the prevention effect of shivering in group C was the best.(4)The level of shivering in the three groups was compared,and the level of shivering in group C was lower than that in group A and B,with statistical significance(P < 0.05),indicating that the degree of shivering in group C was slight.(5)The thermal comfort scores of the three groups were compared at different time points.At T9,the score of group B was lower than that of group A,with statistical significance(P < 0.05).At T1,T4,T6 and T9,the thermal comfort score of group C was lower than that of group A and B,with statistical significance(P < 0.05),The results showed that the thermal comfort of group C was the best.(6)The incidence of perioperative hypothermia,nausea and vomiting in the three groups was compared,Compared with group A and B,there was no perioperative hypothermia in group C,which was statistically significant(P < 0.05).There was no significant difference in the incidence of nausea and vomiting among group A,B and C(P > 0.05),indicating that group C could effectively prevent perioperative hypothermia but had no significant effect on the prevention of nausea and vomiting.Conclusion : The forced air-prewarming could effectively maintain the core temperature stability during perioperative period and reduce perioperative hypothermia and shivering,and significantly improve thermal comfort. |
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