척추마취하 고관절 전치환술 환자의 수술 전 가온이 수술 중 저체온 예방에 미치는 효과
Effect of Preoperative Warming on Prevention of Hypothermia during Surgery in Patients with Total Hip Replacement Arthroplasty under Spinal Anesthesia
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목적: 본 연구는 척추마취하 고관절 전치환술 환자의 수술 시 저체온을 예방하기 위해 수술 전 가온의 효과를 확인하고자 진행되었다. 방법: 무작위 실험연구로 경기도에 위치한 S 대학병원에서 2019년 12월 3일부터 2020년 3월 31일까지 자료를 수집하였고, 컴퓨터 무작위화 프로그램을 이용하여 90명의 연구대상자를 30분 수술 전 가온 군, 15분 수술 전 가온 군, 대조군으로 각 30명씩 배정하였으며 부적절한 자료를 제외하여 최종 88명이 분석에 포함되었다. 자료 분석은 SPSS 21.0 프로그램을 사용하였으며 Chi-square test, ANOVA, 일반화 추정 방정식(Generalized Estimating Equation, GEE)으로 분석하였다. 결과: 마취 유도 후 30분부터 마취 종료 시까지의 체온의 차이에서 30분 수술 전 가온 군이 대조군보다 체온이 유의하게 높았고. 마취시간에 따른 체온의 변화 차이는 마취시간 경과에 따른 체온과 세 군 간의 체온은 유의한 차이를 보였으나 시간과 군 간의 상호작용에서는 통계적으로 유의한 차이가 없었다. 결론: 30분 수술 전 가온을 적용한 군이 수술 전 가온을 적용하지 않은 경우보다 수술 중 체온 하강이 적고, 정상체온 유지에 효과가 있는 것으로 나타나, 30분 수술 전 가온 적용이 수술 동안 저체온 예방에 효과적인 가온 중재방법임을 알 수 있었다.
Abstract
Purpose: The purpose of this study was to evaluate the effect of preoperative warming to prevent hypothermia in surgery for patients undergoing total hip replacement arthroplasty under spinal anesthesia. Methods: A randomized experimental study was conducted. Data were collected at an S University hospital in Gyeonggido from December 3, 2019 to March 31, 2020. A random allocation program was used to randomize participants into intervention and control groups. A total of 90 participants were assigned to the study: 30 people were randomized to a pre-warming group using Bair Hugger forced-air warming blankets(Model 505) 30 minutes before surgery, 30 to a pre-warming group 15 minutes before surgery, or 30 to a control group. The findings from 88 participants were analyzed. For data analysis, x2 test and ANOVA were used utilizing the SPSS 21.0 program. Results: The pre-warming group 30 minutes before surgery had significantly higher body temperature than the control group, from 30 minutes after inducing anesthesia to the end of anesthesia. Body temperature over anesthesia time showed significant differences among the three groups, but there were no statistically significant differences in interactions between time and groups. Conclusion: Warming patients' body for 30 minutes before surgery was effective in maintaining normal body temperature while preventing intraoperative hypothermia.
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