Effects of different temperatures of heat preservation on stress response, anesthesia recovery and bispectral index in patients undergoing gastric cancer surgery

Miao Suqin; Zhao Yu; Lyu Dezhen

doi:10.3760/j.issn.1673-4777.2018.09.019

Abstract：Objective To analyze the effects of the different temperatures of heat preservation on stress response,anesthesia recovery time and bispectral index (BIS) in patients undergoing gastric cancer surgery.Methods From July 2015 to October 2017,113 patients undergoing elective gastric cancer surgery were enrolled at Nanjing General Hospital of Nanjing Military Region.The patients were randomly divided into low temperature group (n =35),high temperature group (n =40) and comprehensive group (n =38).All patients were treated with 37 ℃ infusion and insulation blankets with different temperatures(low temperature group:37 ℃;high temperature group:45 ℃;comprehensive group:45 ℃ 1 h,37 ℃).Baseline medical data and operation records,changes of nasopharyngeal temperature during perioperative period,anesthetic effect,waking time,BIS and stress indicators were analyzed.Results Baseline information were similar among the three groups (P ＞ 0.05).Nasopharyngeal temperatures at 60,120 min after anesthesia induction and at the end of surgery in high temperature group and comprehensive group were significantly higher than those in low temperature group(P ＜ 0.05).BIS after withdrawal of anesthetics showed no significant difference among the three groups (P ＞ 0.05).Waking time,time of anesthetic withdrawal to BIS ≥ 80,consciousness recovery time,mechanical ventilation time and postanesthesia intensive care unit residence time in comprehensive group were significantly shorter than those in low temperature group and high temperature group[(17±6)minvs (24 ±8),(22±8)min;(18±6)min vs (28 ±8),(26±8)min;(46±7) min vs (80 ± 11),(77 ± 11)min;(24 ±7) min vs (38 ± 8),(37 ± 8)min;(50 ± 11) min vs (83 ± 14),(81 ±14)min] (P ＜ 0.05).Propofol effect-site concentration when BIS ≥ 80 in comprehensive group was significantly higher than that in low temperature group and high temperature group[(1.21 ±0.28)mg/L vs (0.88 ±0.36),(0.92 ±0.34)mg/L] (P ＜ 0.05).After surgery,levels of C-reactive protein,norepinephrine and epinephrine were significantly higher than those before surgery;the levels in comprehensive group were significantly lower than those in low temperature group and high temperature group (P ＜ 0.05).Conclusion In patients undergoing gastric cancer surgery,37 ℃ constant infusion combined with heat preservation with thermal blanket at 45 ℃ then 37 ℃ can effectively relieve stress,promote anesthesia recovery and BIS recovery.