요추 수술 환자의 수술 중 강제 공기 가온 요법 적용 부위에 따른 효과

Abstract

Purpose Hypothermia, which represents the drop in core body temperature below 36℃, occurs in 21∼78.6% patients undergoing surgery and can cause side effects such as coagulation disorder, blood loss, delayed drug metabolism, shivering, pain, and surgical site infection. This study aimed to determine the effects of forced air warming therapy in preventing hypothermia of the upper or lower body in patients who underwent lumbar spine surgery.

Method This quasi-experimental study by a non-equivalent design included 68 adult patients who underwent lumbar surgery from February 4, 2022, to October 28, 2022, at an orthopedic hospital. Patients receiving the forced-air warming therapy to the upper body and lower body were divided into experimental and control groups, respectively. During surgery, the core body temperature was measured in the esophagus at 15-min intervals. After surgery, the tympanic body temperature, shivering, and pain were assessed in the recovery room. As an indicator of the inflammatory response, C-reactive protein (CRP) levels were measured 2, 6, and 13 days after surgery. Statistical analysis was conducted using the Χ2 test, Fisher's exact test, independent t-test, and repeated measures ANOVA employing the IBM SPSS Statistics 29.0 program.

Result During surgery, the core body temperature was significantly higher in the upper body group (F=6.97, p<.001) than that of the lower body group, and after surgery, the core body temperature was significantly higher in the upper body group (t=5.95, p<.001) than that of the lower body group. Further, the upper body group showed a significantly (t=-8.00, p<.001) lower pain than that of the lower body group. However, no significant differences were observed in postoperative shivering (t=-1.42, p=.162) and CRP levels (F=0.67, p=.514) between the two groups.

Conclusion In patients undergoing lumbar surgery in the prone position, forced-air warming therapy to the upper body was more effective in preventing hypothermia during and after surgery than when applied to the lower body. Hence, during the surgery of such patients, forced-air warming therapy should be applied to the upper body.

Key words: Hypothermia, Spine, Surgery, Forced-air warming