Effect on thermoregulatory responses in patients undergoing a tympanoplasty in accordance to the anesthetic techniques during PEEP: a comparison between inhalation anesthesia with desflurane and TIVA
Korean Journal of Anesthesiology 2014³â 67±Ç 1È£ p.32 ~ p.37
Á¤±âÅÂ(Jung Ki-Tae) - Chosun University School of Medicine Department of Anesthesiology and Pain Medicine
±è»óÈÆ(Kim Sang-Hun) - Chosun University School of Medicine Department of Anesthesiology and Pain Medicine
ÀÌÇö¿µ(Lee Hyun-Young) - Chosun University School of Medicine Department of Anesthesiology and Pain Medicine
Á¤Á¾´Þ(Jung Jong-Dal) - Chosun University School of Medicine Department of Anesthesiology and Pain Medicine
À¯º´½Ä(Yu Byung-Sik) - Chosun University School of Medicine Department of Anesthesiology and Pain Medicine
ÀÓ°æÁØ(Lim Kyung-Joon) - Chosun University School of Medicine Department of Anesthesiology and Pain Medicine
¼Ò±Ý¿µ(So Keum-Young) - Chosun University School of Medicine Department of Anesthesiology and Pain Medicine
ÀÌÁÖ¿µ(Lee Ju-Young) - Chosun University Hospital Department of Anesthesiology and Pain Medicine
¾ÈÅÂÈÆ(An Tae-Hun) - Chosun University School of Medicine Department of Anesthesiology and Pain Medicine
Abstract
Background: It has been known that positive end-expiratory pressure (PEEP) increases the vasoconstriction threshold by baroreceptor unloading. We compared the effect on the thermoregulatory responses according to anesthetic techniques between an inhalation anesthesia with desflurane and a total intravenous anesthesia (TIVA) with propofol and reminfentanil when PEEP was applied in patients undergoing tympanoplasty.
Methods: Forty-six patients with a scheduled tympanoplasty were enrolled and the patients were divided in two study groups. Desflurane was used as an inhalation anesthetic in group 1 (n = 22), while TIVA with propofol and remifentanil was used in group 2 (n = 24). PEEP was applied by 5 cmH2O in both groups and an ambient temperature was maintained at 22-24¡É during surgery. The core temperature and the difference of skin temperature between forearm and fingertip were monitored for about 180 minutes before and after the induction of general anesthesia.
Results: The final core temperature was significantly higher in group 2 (35.4 ¡¾ 0.7¡É) than in group 1 (34.9 ¡¾ 0.5¡É). Peripheral thermoregulatory vasoconstriction was found in 5 subjects (23%) in group 1 and in 21 subjects (88%) in group 2. The time taken for reaching the thermoregulatory vasoconstriction threshold was 151.4 ¡¾ 19.7 minutes in group 1 and 88.9 ¡¾ 14.4 minutes in group 2.
Conclusions: When PEEP will be applied, anesthesia with TIVA may have more advantages in core temperature preservation than an inhalation anesthesia with desflurane.
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Desflurane, Inhalation anesthesia, Intravenous anesthesia, Positive end expiratory pressure, Thermoregulation, Vasoconstriction
KMID :
0356920140670010032
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