Reevaluating anesthesia maintenance strategies to prevent intraoperative hypothermia in hip arthroplasty: a randomized controlled trial

重新评估麻醉维持策略以预防髋关节置换术中低体温:一项随机对照试验

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Abstract

BACKGROUND: Intraoperative hypothermia is a common occurrence influenced by multiple factors, and the effect of maintenance anaesthetic agents on intraoperative temperature remains controversial. In this study, we compared the incidence of hypothermia between inhalational and intravenous maintenance anaesthesia under identical induction protocols. METHODS: 172 adult patients were randomly assigned to receive maintenance anaesthesia with either sevoflurane (2%-3%) or intravenous agents (propofol and remifentanil). The primary endpoint was the incidence of intraoperative hypothermia. RESULTS: There was no significant difference in the incidence of intraoperative hypothermia between the inhalational and intravenous maintenance groups (55/86 [64%] vs. 52/86 [60.5%]; RR = 1.06; 95% CI, 0.84 to 1.34; P = 0.753). The lowest intraoperative core temperature did not differ significantly between groups (median [IQR]: 35.7 [35.5-36.0] vs. 35.9 [35.5-36.2]°C; P = 0.107); however, the final core temperature at the end of surgery was significantly lower in the inhalational group (median [IQR]: 35.8 [35.6-36.1] vs. 36.1 [35.6-36.4]°C; P = 0.004). Emergence time was significantly longer in the inhalational group (P < 0.001). All other baseline, perioperative, and safety outcomes were comparable between the two groups. CONCLUSIONS: In patients undergoing total hip arthroplasty, there was no significant difference in the incidence of intraoperative hypothermia between inhalational and intravenous maintenance anaesthesia.

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