최소 단어 이상 선택하여야 합니다.
최대 10 단어까지만 선택 가능합니다.
다음과 같은 기능을 한번의 로그인으로 사용 할 수 있습니다.
NTIS 바로가기Journal of Korean biological nursing science, v.17 no.3, 2015년, pp.236 - 244
이서현 (삼성서울병원 간호부) , 윤혜상 (가천대학교 간호대학)
Purpose: The study was conducted to identify factors affecting the intraoperative core body temperature (CBT) of surgical patients under general anesthesia. Methods: This study was performed through a prospective descriptive research design. The sample consisted of 138 patients who had undergone ele...
핵심어 | 질문 | 논문에서 추출한 답변 |
---|---|---|
저체온은 무엇인가? | 전신마취는 인체의 정상적인 체온조절기능을 억제하여 전신마취하의 수술환자에게 저체온이 발생할 가능성이 높다[1]. 저체온은 심부체온이 36°C 미만으로 저하되는 것으로[2,3] 전신마취하에 수술을 받는 환자의 60-70%에서 발생된다고 한다[2-5]. 전신마취 유도 후 첫 1시간 동안 1. | |
수술 및 마취관련 간호실무에서 체온 관련 간호중재는 수술 및 마취 관련 합병증의 예방인데 그것이 중요한 이유는? | 저체온은 순환 혈중 카테콜라민을 증가시켜 말초혈관 수축, 빈맥 및 고혈압 등으로 심혈관계에 부담을 줄 수 있고[9], 혈액응고반응을 지연시켜 출혈 가능성을 높이며 면역기능의 저하로 창상회복을 지연시켜 수술부위감염의 위험성을 높이기도 한다[5,10,11]. 또한 수술 중 저체온은 수술 및 마취종료 후 저체온으로 이어지면서 마취로부터의 회복 과정 중 전율을 초래하고, 수술종료 후 잔여 마취제 및 근이완제의 배출지연으로 수술 후 회복을 지연시키기도 한다[2,4,12,13]. 특히 수술 및 마취종료 후의 전율은 인체의 산소 소모량을 5-6배까지증가시켜[6,14] 심혈관계 및 호흡기계 관련 질환자에게 저산소증을 악화시키는 요인이 되기도 한다. 따라서 수술 및 마취관련 간호실무에서 체온 관련 간호중재는 수술 및 마취 관련 합병증의 예방에 매우 중요하다고 생각한다. | |
전신마취의 위험성은? | 전신마취는 인체의 정상적인 체온조절기능을 억제하여 전신마취하의 수술환자에게 저체온이 발생할 가능성이 높다[1]. 저체온은 심부체온이 36°C 미만으로 저하되는 것으로[2,3] 전신마취하에 수술을 받는 환자의 60-70%에서 발생된다고 한다[2-5]. |
Lenhardt R. The effect of anesthesia on body temperature control. Frontiers in Bioscience. 2010;S2:1145-1154.
Kiekkas P, Poulopoulou M, Papahatzi A, Souleles P. Effects of hypothermia and shivering on standard PACU monitoring of patients. AANA Journal. 2005; 73(1):47-53.
Kongsayreepong S, Chaibundit C, Chadpaibool J, Komoltri C, Suraseranivongse S, Suwannanonda P, et al. Predictor of core hypothermia and the surgical intensive care unit. Anesthesia and Analgesia. 2003;96(3):826-833. http://dx.doi.org/10.1213/01.ANE.0000048822.27698.28
Abelha FJ, Castro MA, Neves AM, Landeiro NM, Santos CC. Hypothermia in a surgical intensive care unit. BMC Anesthesiology.2005;5:7. http://dx.doi.org/ 10.1186/1471-2253-5-7
Kurz A, Sesslser DI, Lenhardt R. Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. The New England Journal of Medicine. 1996;334(19):1209-1215.
Kurz A, Sessler DI, Christensen R, Dechert M. Heat balance and distribution during the core-temperature plateau in anesthetized humans. Anesthesiology. 1995;83(3):491-499.
Matsukawa T, Sessler DI, Sessler AM, Schroeder M, Ozaki M, Kurz A, et al. Heat flow and distribution during induction of general anesthesia. Anesthesiology. 1995;82(3):662-673.
Yamakage M, Kamada Y, Honma Y, Tsujiguchi N, Namiki A. Predictive variables of hypothermia in the early phase of general anesthesia. Anesthesia and Analgesia. 2000;90(2):456-459. http://dx.doi.org/10.1213/00000539-200002000-00040
Kasai T, Hirose M, Yaegashi K, Matusukaroa T, Takamata A, Tonaka Y. Preoperative risk factors of intraoperative hypothermia in major surgery under general anesthesia. Anesthesia and Analgesia. 2002;95(5):1381-1383. http://dx.doi.org/10.1097/00000539-200211000-00051
Sarti A, Recanati D, Furlan S. Thermal regulation and intraoperative hypothermia. Minerva Anestesiologica. 2005;71(6):379-383.
Winkler M, Akca O, Birkenberg B, Hetz H, Scheck T, Arkilic CF, et al. Aggressive warming reduces blood loss during hip arthroplasty. Anesthesia and Anal gesia. 2000;91(4):978-984.
Connor EL, Wren KR. Detrimental effects of hypothermia: A systems analysis. Journal of Perianesthesia Nursing. 2000;15(3):151-155. http://dx.doi.org/10.1053/jpan.2000.7508
Lenhardt R, Marker E, Goll V, Tschernich H, Kurz A, Sessler DI, et al. Mild intraoperative hypothermia prolongs postanesthetic recovery. Anesthesiology. 1997;87(6): 1318-1323.
Eberhart LHJ, Doderlein F, Eisenhardt G, Kranke P, Sessler DI, Torossian A, et al. Independent risk factors for postoperative shivering. Anesthesia and Analgesia. 2005;101(6):1849-1857.
Frank SM, Beattie C, Christopherson R, Norris EJ, Rock P, Parker S, et al. Epidural versus general anesthesia, ambient operating room temperature and patients age as predictors of inadvertent hypothermia. Anesthesiology. 1992;77(2):252-257.
Ozaki M, Sessler DI, Suzuki H, Ozaki K, Tsunoda C, Atarashi K. Nitrous oxide decreases the threshold for vasoconstriction less than sevoflurane or isoflurane. Anesthesia and Analgesia. 1995;80(6):1212-1216.
Ayres U. Older people and hypothermia: The role of the anaesthetic nurse. British Journal of Nursing. 2004;13(7):396-403.
de Brito Poveda V, Galvao CM, dos Santos CB. Factors associated to the development of hypothermia in the intraoperative period. Revista Latino-Americana de Enfermagem. 2009;17(2):228-233.
Kim EJ, Yoon H. Preoperative factors affecting the intraoperative core body temperature in abdominal surgery under general anesthesia. Clinical Nurse Specialist. 2014;28(5): 268-276. http://dx.doi.org/10.1097/NUR.0000000000000069
Macario A, Dexter F. What are the most important risk factors for a patient's developing intraoperative hypothermia? Anesthesia and Analgesia. 2002;94(1):215-220. http://dx.doi.org/10.1213/00000539-200201000-00042
Ozaki M, Sessler DI, Matsukawa T, Ozaki K, Atarashi K, Negishi C, et al. The threshold for thermoregulatory vasoconstriction during nitrous oxide/sevoflurane anesthesia is reduced in the elderly. Anesthesia and Analgesia. 1997;84(5):1029-1033.
Flores-Maldonado A, Guzman-Llanez Y, Castaneda-Zarate S, Pech-Colli J, Alvarez-Nemegyei J, Cervera-Saenz M, et al. Risk factors for mild intraoperative hypothermia. Archives of Medical Research. 1997;28(4):587-590.
Mills SJ, Holland DJ, Hardy AE. Operative field contamination by the sweating surgeon. The Australian and New Zealand Journal of Surgery. 2000;70(12):837-839.
National Institute for Health and Clinical Excellence. The management of inadvertent perioperative hypothermia in adults [Internet]. Manchester: National Institute for Health and Clinical Excellence; 2008 [Cited 2014 Oct 5]. Avaliable from: http://www.nice.org.uk/guidance/cg65/resources/guidance-inadvertent-perioperative-hypothermia-pdf.
Moore SS, Green CR, Wang FL, Pandit SK, Hurd WW. The role of irrigation in the development of hypothermia during laparoscopic surgery. American Journal of Obstetrics and Gynecology. 1997;176(3):598-602.
Kurz A, Plattner O, Sessler DI, Huemer G, Redl G, Lackner F. The threshold for thermoregulatory vasoconstriction during nitrous oxide/isoflurane anesthesia is lower in elderly than in young patients. Anesthesiology. 1993;79(3):465-469.
El-Gamal N, El-Kassabany N, Frank SM, Amar R, Khabar HA, El-Rahmany HK, et al. Age-related thermoregulatory differences in a warm operating room environment (approximately $26^{\circ}C$ ). Anesthesia and Analgesia. 2000;90(3):694-698. http://dx.doi.org/10.1097/00000539-200003000-00034
De Mattia AL Barbosa MH, De Matia Rocha A, Farisas HL, Santos CA, Santos DM. Hypothermia in patients during the perioperative period. Revista da Escola de Enfermagem da USP. 2012;46(1):60-66.
Tappen RM, Andre SP. Inadvertent hypothermia in elderly surgical patients. AORN Journal. 1996;63(3):639-644.
*원문 PDF 파일 및 링크정보가 존재하지 않을 경우 KISTI DDS 시스템에서 제공하는 원문복사서비스를 사용할 수 있습니다.
오픈액세스 학술지에 출판된 논문
※ AI-Helper는 부적절한 답변을 할 수 있습니다.