Application of whole-course active thermal insulation in operating room during inguinal hernia surgery for the elderly

doi:10.3877/cma.j.issn.1674-392X.2024.01.022

Abstract

Abstract:

Objective

To explore the application effect of whole-course active thermal insulation strategy in operation room during inguinal hernia surgery for the elderly.

Methods

A total of 86 elderly patients with inguinal hernia admitted to Beijing Jishuitan Hospital were enrolled as the subjects between October 2020 and October 2022. According to 1:1 simple random number table method, they were divided into observation group and control group, with 43 cases in each group. The control group was given routine thermal insulation strategy in operating room, while observation group was given whole-course active thermal insulation strategy in operating room. The surgical related indexes, perioperative temperature [immediately after entering the room (T1), 10 min after anesthesia (T2), 20 min after the start of surgery (T3), the end of surgery (T4)], stress indexes [cortisol, epinephrine, norepinephrine (NE)] before and 2 d after surgery, and the incidence of intraoperative adverse events were compared between the two groups.

Results

The intraoperative blood loss, tracheal extubation time and recovery time of autonomous consciousness in observation group were significantly lower/shorter than those in control group [(18.36±4.65) ml vs (34.53±4.92) ml, (23.65±4.27) min vs (27.76±4.35) min, (20.12±3.46) min vs (25.85±3.77) min] (P<0.05). At T2, T3 and T4, body temperature in both groups decreased continuously, which was higher in observation group than in control group [(36.71±0.18) ℃ vs (36.41±0.20) ℃, (36.68±0.21) ℃ vs (36.12±0.23) ℃, (36.65±0.24) ℃ vs (35.86±0.25) ℃] (P<0.05). On the second day after surgery, levels of cortisol, epinephrine and NE in both groups were significantly increased, which were lower in observation group than in control group (P<0.05). The incidence of hypothermia and chill in observation group was significantly lower than that in control group (4.65% vs 18.60%, 0 vs 13.95%) (P<0.05).

Conclusion

The whole-course active thermal insulation strategy in operating room can reduce the incidence of hypothermia and chill in elderly patients undergoing inguinal hernia surgery, which is beneficial to maintain intraoperative body temperature and reduce stress injury.

Key words: Hernia, inguinal, Operating room, Whole-course active thermal insulation, Stress response

Dandan Sun, Hongsha Ye, Yajing Tian. Application of whole-course active thermal insulation in operating room during inguinal hernia surgery for the elderly[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2024, 18(01): 111-115.

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URL: https://zhshfbwkzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-392X.2024.01.022

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References 21

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组别	例数	年龄(岁,±s)	性别[例(%)]		疝分类[例(%)]		合并疾病[例(%)]
组别	例数	年龄(岁,±s)	男性	女性	直疝	斜疝	高血压	糖尿病
观察组	43	65.86±2.44	35(81.40)	8(18.60)	14(32.56)	29(67.44)	7(16.28)	4(9.30)
对照组	43	65.75±2.56	32(74.42)	11(25.58)	12(27.91)	31(72.09)	9(20.93)	3(6.98)
t/χ²		0.204	0.608		0.221		0.307	0.156
P		0.839	0.436		0.639		0.579	0.693

组别	例数	年龄(岁,±s)	性别[例(%)]		疝分类[例(%)]		合并疾病[例(%)]
组别	例数	年龄(岁,±s)	男性	女性	直疝	斜疝	高血压	糖尿病
观察组	43	65.86±2.44	35(81.40)	8(18.60)	14(32.56)	29(67.44)	7(16.28)	4(9.30)
对照组	43	65.75±2.56	32(74.42)	11(25.58)	12(27.91)	31(72.09)	9(20.93)	3(6.98)
t/χ²		0.204	0.608		0.221		0.307	0.156
P		0.839	0.436		0.639		0.579	0.693

组别	例数	术中出血量(ml)	手术时间(min)	气管拔管时间(min)	自主意识恢复时间(min)
观察组	43	18.36±4.65	50.89±7.72	23.65±4.27	20.12±3.46
对照组	43	34.53±4.92	50.96±7.69	27.76±4.35	25.85±3.77
t		15.701	0.042	4.421	7.342
P		<0.001	0.966	<0.001	<0.001

组别	例数	术中出血量(ml)	手术时间(min)	气管拔管时间(min)	自主意识恢复时间(min)
观察组	43	18.36±4.65	50.89±7.72	23.65±4.27	20.12±3.46
对照组	43	34.53±4.92	50.96±7.69	27.76±4.35	25.85±3.77
t		15.701	0.042	4.421	7.342
P		<0.001	0.966	<0.001	<0.001

组别	例数	T1	T2	T3	T4
观察组	43	36.78±0.19	36.71±0.18	36.68±0.21	36.65±0.24
对照组	43	36.79±0.17	36.41±0.20	36.12±0.23	35.86±0.25
t		0.257	7.311	11.791	18.732
P		0.798	<0.001	<0.001	<0.001

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