The effect of intraoperative mild hypothermia on the development of perioperative cardiac ischemia

我们评估了与轻度低温相关的围手术期心肌缺血的风险，作为神经外科手术的辅助管理。47例神经外科择期手术患者随机分为低温组（H，n = 24）和常温组（N，n = 23）。H组冷却至34.5 ℃（鼓膜温度）后复温，N组保持常温。两组患者的年龄、性别、体重、身高、心脏病发生率、麻醉方式、手术内容等人口学资料无差异。在最低点（34.6 * 0.5对35.9 * 0.6，平均值 * SD）和麻醉结束时（35.9 * 0.9对36.5 * 0.5），H组的温度显著低于N组。术后心电图ST段压低3例（H组），寒战2例（N组）。这些发生率无统计学显著性（卡方检验，p设定为0.05）。我们得出结论，术中轻度低温可能不会增加接受神经外科手术的患者围手术期心肌缺血的风险。

We evaluated the risk of perioperative cardiac ischemia associated with mild hypothermia as adjunct management for neurosurgical procedures. Forty-seven elective neurosurgical patients were randomly assigned to either hypothermic group (H, n=24) or normothermic one (N, n=23). Patients in group H were cooled to and maintained at 34.5 degrees C (tympanic membrane temperature) and rewarmed after main neurosurgical manipulation, while ones in group N were kept in normothermic state. Cardiac ischemia was diagnosed with Holter electrocardiogram monitored for 24 hours after admission to the operating room.No differences were observed in demographic data including age, gender, weight, height, rate of having cardiac disease, anesthesia methods, and contents of surgery. Temperature was significantly lower in group H than N both at the lowest point(34.6*O.5 vs 35.9*0.6, means*SD) and at the conclusion of anesthesia (35.9*0.9 vs 36.5*0.5). Electrocardiographic ST segmental depression was observed in 3 (group H) and 5 cases (group N), and postoperative shivering occurred in 3 (group H) and 2 cases (group N), respectively. Those incidences were not statistically significant (chi-square test, p was set at 0.05). We concluded that intraoperative mild hypothermia might not increase the risk of perioperative cardiac ischemia in patients underwent neurosurgical procedures.