| Objective:To investigate effects of the forced-air-warming blanket on body temperature and cisatracurium timeliness in patients undergoing laparoscopic selective general anesthesia.Methods:50 patients,ASA III,undergoing elective laparoscopic surgery under general anesthesia,were randomly assigned into two groups:heat preservation group?25 cases in group T?:start inflatable blanket when patients became stable after entering the operating room,choose forced-air temperature 38?;Non-heat preservation group?25 cases in group C?:without using inflatable blanket.The patients were premedicated with phenobarbital 0.1mg and atropine 0.5mg intramuscular.Monitoring of heart rate,blood pressure,pulse oxygen,pressure of end-tidal carbon dioxide,bispectral index,train-of-four stimulation.Using the same anesthesia induction and maintenance methods.Anesthesia induction:the plasma target concentration of propofol was set at 1.5?g/ml,6minutes to reach the target concentration.With the start of propofol,sufentanil0.5?g/kg,etomidate 0.2mg/kg,cisatracurium 0.1mg/kg were intravenously injected.The effect of ventricular concentration of remifentanil was set at0.5ng/ml,starting 1 minute before endotracheal intubation.Maintenance of anesthesia:combined intravenous anesthesia and inhalation anesthesia,maintain the plasma target concentration of propofol between 1.52.0?g/ml,the effect of ventricular concentration of remifentanil between 1.52.0ng/ml and control the sevoflurane output concentration 1vol%.If the concentration of remifentanil reached 2.0ng/ml,add sufentanil 510?g according to the change of heart rate.Heart rate and mean arterial pressure were maintained atą20%baseline.Controled BIS between 4060.Cisatracurium was added?1 times ED95 0.05mg/kg?when T1 first recover after induction.During the operation,cisatracurium was supplemented?1 times ED95 0.05mg/kg?when T1>10%.Muscle relaxant accelerometer was used to monitor the onset time of cisatracurium?from induction to TOF disappearance?,T1 appearance time after induction,single additional administration time to T1>10%intraoperative and muscle relaxation recovery time from T1>10%to TOF>25%after the last additional administration.No muscle relaxant was added 40 minutes before the end of the operation,and no antagonism was given after the operation.Recorded and compared the two groups of patients'tympanic membrane temperature,mean arterial pressure,heart rate,pulse oxygen and pressure of end-tidal carbon dioxide at entering operation room after 5 minutes?T0?,30 minutes after anesthesia?T1?,60 minutes after anesthesia?T2?,90 minutes after anesthesia?T3?,120minutes after anesthesia?T4?,150 minutes after anesthesia?T5?,180 minutes after anesthesia?T6?,210 minutes after anesthesia?T7?,10 minutes after extubation?T8?.All data use SPSS17.0 application data processing software.Results:There were no statistically significant differences among the two groups in temperature at T0?P>0.05?.Both groups showed a trend of hypothemia after 30minutes of anesthesia,but there were also no statistically significant differences?P>0.05?.The temperature differences were statistically significant between the two groups after 90 minutes of anesthesia?P<0.05?,and the temperature of the T group showed a rising trend after 120 minutes of anesthesia.Compared to group T,cisatracurium induction onset time,first T1appearance time,single dose to T1>10%time,muscle relaxation recovery time were all prolonged in group C patients,and the differences were statistically significant?P<0.05?.There were no statistically significant differences among the two groups in gender ratio,age,body mass index,operating room temperature,PetCO2,HR,MAP,BIS and pneumoperitoneum pressure?P>0.05?.Conclusion:?1?After 90 minutes of anesthesia,the body temperature of patients undergoing laparoscopic surgery under general anesthesia decreased significantly,and low temperature could prolong the action time of cisatracurium.?2?The forced-air-warming blanket can significantly improve the hypothermia of patients undergoing laparoscopic surgery under general anesthesia after 90minutes of anesthesia,and has a rewarming effect after 120 minutes of anesthesia. |
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