Avaliação da transmissão de temperatura da resina acrílica para os ossos cortical e medular por meio de redes de Bragg / Evaluation of the temperature transmission of the acrylic resin to the cortical and medullary bones through the Bragg's grating

O objetivo do estudo foi avaliar a alteração de temperatura nos ossos cortical e medular gerados pela resina acrílica na união dos transferentes por meio das redes de Bragg. Foram selecionados dois implantes cone morse Titamax (Neodent) 4 mm x 15 mm. Os implantes foram inseridos em um osso artificial da marca Sawbones, de acordo com as instruções do fabricante, cuja localização dos pilares foi referente aos dentes 44 e 46 com ausência do dente 45. Sobre os implantes foram instalados transferentes para a técnica aberta. Os transferentes foram esplintados por meio de um fio dental e aplicação de resina acrílica pela técnica de Nealon. Foram selecionadas duas resinas acrílicas: Duralay e GC Pattern LS. Dois sensores de fibra ótica foram posicionados, sendo um próximo à região cervical e outro na região apical do implante. Os sensores mensuraram a transferência de calor para o osso cortical e medular com o auxílio de uma pasta térmica (Implastec). Os dados foram submetidos à análise estatística por meio dos testes de normalidade de Shapiro-Wilk, ANOVA a dois critérios e teste de múltiplas comparações post hoc LSD (p<0,05). Foram encontradas diferenças significativas entre Duralay apical eGC Pattern LS cervical, GC Pattern LS cervical eGC Patternapical (p<0,05). As redes de Bragg apresentaram-se sensíveis para a mensuração da transferência de temperatura do transferente para os ossos cortical e medular. A partir dos resultados obtidos, pode-se afirmar que não há risco de necrose óssea (AU).

The purpose of the study was to evaluate the temperature change in the cortical and medullary bones generated by the acrylic resin in the union of transferents through the Bragg's grating. Two cone morse Titamax (Neodent) 4 mm x 15 mm implants were selected. The implants were inserted into a Sawbones artificial bone according to the manufacturer's instructions, abutment location were teeth 44 and 46 with absence of tooth 45. On the implants tranfers were installed for the open technique. The transfers were splined by means of a dental floss and acrylic resin application by the Nealon technique. Two acrylic resins were selected: Duralay and GC Pattern LS. Two fiber optic sensors were positioned, one near the cervical region and other at the implant apical region. The sensors measured the heat transfer to the cortical and medullary bones with the help of a thermal paste (Implastec). Data were submitted to statistical analysis using Shapiro-Wilk normality tests, two way ANOVA, and post hoc LSD multiple comparisons (p <0.05). Significant differences were found between Duralay apical and GC Pattern LS cervical, GC Pattern LS cervical and GC apical Pattern (p <0.05). The Bragg's grating were sensitive to temperature transference measurement from transfers to the cortical and medullary bones. From the results obtained, it is possible to ssure that there is no risk of bone necrosis (AU).

The Effects of Active Warming on Pain, Temperature, and Thermal Discomfort in Postoperative Patients after General Anesthesia for Abdominal Surgery / 중환자간호학회지

PURPOSE: This study investigated the effects of active warming using a Warm Touch warming system or a cotton blanket in postoperative patients after general anesthesia for abdominal surgery.METHODS: This quasi-experimental study utilized two experimental groups and one control group: a cotton-blanket group (n = 25) were warmed with a cotton blanket and a sheet; a forced-air warming group (n = 24) were warmed with a Warm Touch warming system, a cotton blanket, and a sheet; and a control group (n = 25) were warmed with a sheet. Measurement variables were postoperative pain, body temperature, and thermal discomfort. Data were analyzed using a one-way ANOVA, χ2-tests, Fisher's exact test, and a repeated measures ANOVA.RESULTS: The effects of active warming using a Warm Touch warming system and a cotton blanket on postoperative patients was significant in reducing pain (F = 13.91, p < .001) and increasing body temperature (F = 12.49, p < .001).CONCLUSION: Active warming made a significant difference in pain and body temperature changes. Active warming methods may help patients' postoperative recovery and prevent complications. Further research is needed to explore the effects and side effects of active warming on recovering normothermia.

Effects of 37℃ Carbon Dioxide Pneumoperitoneum on Core Body Temperature, Systolic Blood Pressure, Heart Rate and Acid-Base Balance: A Randomized Double-blind Controlled Trial

PURPOSE: The purpose of this study was to compare the effects of 21℃ CO₂ and 37℃ CO₂ pneumoperitoneum on body temperature, blood pressure, heart rate, and acid-base balance. METHODS: Data were collected at a 1300-bed university hospital in Incheon, from February through September 2012. A total of 74 patients who underwent laparoscopic colectomy under general anesthesia with desflurane were randomly allocated to either a control group or an experimental group. The control group received 21℃ CO₂ pneumoperitoneum; the experimental group received 37℃ CO₂ pneumoperitoneum. The pneumoperitoneum of the two groups was under abdominal pressure 15 mmHg. Body temperature, systolic blood pressure, heart rate and acid-base balance were assessed at 30 minutes and 90 minutes after pneumoperitoneum, and again at 30 minutes after arriving at the Post Anesthesia Care Unit. RESULTS: Body temperature in the 37℃ CO2 pneumoperitoneum group was significantly higher (F=9.43, p<.001) compared to the 21℃ CO₂ group. However, there were no statistically significant differences in systolic blood pressure (p=.895), heart rate (p=.340), pH (p=.231), PaCO₂ (p=.490) and HCO3- (p=.768) between the two groups. CONCLUSION: Pneumoperitoneum of 37℃ CO₂ is effective for the increase of body temperature compared to pneumoperitonium of 21℃ CO₂, and it does not result in a decrease of blood pressure, heart rate or acid-base imbalance.

Incidence of Hypothermia and Factors Associated with Body Temperature Changes during Surgery in Burned Patients

PURPOSE: The study aimed to evaluate the changes of body temperature and to identify the factors related to changes during surgery in burned patients. METHODS: A retrospective study was conducted by reviewing the medical records of 439 adult burned patients who had a surgery under general anesthesia at the Burn Center of a university hospital. RESULTS: After surgery, body temperature of the burned patients declined from 36.6℃ to 35.2℃; 52.2% were hypothermia. There were significant differences in the changes of body temperature according to the participants' characteristics including American society of anesthesiologists physical status, type of burn injury, total burn surface area, range of exposure, operation time, anesthesia time, amount of fluid, blood transfusion, use of tourniquet, and the method of warming therapy. Factors that influence the temperature changes were total burn surface area (β=0.26), operation time (β=0.25), amount of fluid (0.20), and warming therapy including ‘Room temperature setting + Heated circuit + Hot line’(β=0.09) and ‘Room temperature setting+one of others’(β=0.08). CONCLUSION: Burned patients experienced a decrease of their body temperature during surgery despite of warming therapy. A nursing protocol is needed to provide an appropriate warming therapy based on their characteristics in burned patients.

Core Temperature Evaluation in Different Body Parts in Patients Undergoing Laparoscope Surgery under Total Intravenous Anesthesia / 기본간호학회지

PURPOSE: The trend of body temperature change during laparoscopic surgery and the most adequate site for monitoring temperature measurements have not been investigated thoroughly. In this study body temperature change during laparoscopic surgery was measured and measurements of the tympanic, esophageal, and nasopharyngeal core temperatures in surgical patients with total intravenous anesthesia were compared. METHODS: From February to October 2013, 28 laparoscopic surgical patients were recruited from a tertiary hospital in Seoul. The patients' core temperature was measured 12 times at ten minute intervals from ten minutes after the beginning of endotracheal intubation. RESULTS: Repeated measure of core temperatures indicated a significant difference according to body part (p=.033), time of measure (p<.001) and the reciprocal interaction between body part and time of measure (p<.027). The core temperatures were highest at tympany location, lowest at nasopharynx. The amount of temperature change was least for the esophagus (36.10~36.33degrees C), followed by nasopharynx and tympany. CONCLUSION: The esophageal core temperature showed the highest stability followed by nasopharyngeal and tympanic temperature. Therefore, close observations are required between 10~20minutes after the beginning of the operation.

Comparison of two fluid warming devices for maintaining body core temperature during living donor liver transplantation: Level 1 H-1000 vs. Fluid Management System 2000 / 대한마취과학회지

BACKGROUND: Rapid fluid warming has been a cardinal measure to maintain normothermia during fluid resuscitation of hypovolemic patients. A previous laboratory simulation study with different fluid infusion rates showed that a fluid warmer using magnetic induction is superior to a warmer using countercurrent heat exchange. We tested whether the simulation-based result is translated into the clinical liver transplantation. METHODS: Two hundred twenty recipients who underwent living donor liver transplantation between April 2009 and October 2011 were initially screened. Seventeen recipients given a magnetic induction warmer (FMS2000) were matched 1 : 1 with those given a countercurrent heat exchange warmer (Level-1 H-1000) based on propensity score. Matched variables included age, gender, body mass index, model for end-stage liver disease score, graft size and time under anesthesia. Core temperatures were taken at predetermined time points. RESULTS: Level-1 and FMS groups had comparable core temperature throughout the surgery from skin incision, the beginning/end of the anhepatic phase to skin closure. (P = 0.165, repeated measures ANOVA). The degree of core temperature changes within the dissection, anhepatic and postreperfusion phase were also comparable between the two groups. The minimum intraoperative core temperature was also comparable (Level 1, 35.6degrees C vs. FMS, 35.4degrees C, P = 0.122). CONCLUSIONS: A countercurrent heat exchange warmer and magnetic induction warmer displayed comparable function regarding the maintenance of core temperature and prevention of hypothermia during living donor liver transplantation. The applicability of the two devices in liver transplantation needs to be evaluated in various populations and clinical settings.

Comparison of two fluid warming devices for maintaining body core temperature during living donor liver transplantation: Level 1 H-1000 vs. Fluid Management System 2000 / 대한마취과학회지

BACKGROUND: Rapid fluid warming has been a cardinal measure to maintain normothermia during fluid resuscitation of hypovolemic patients. A previous laboratory simulation study with different fluid infusion rates showed that a fluid warmer using magnetic induction is superior to a warmer using countercurrent heat exchange. We tested whether the simulation-based result is translated into the clinical liver transplantation. METHODS: Two hundred twenty recipients who underwent living donor liver transplantation between April 2009 and October 2011 were initially screened. Seventeen recipients given a magnetic induction warmer (FMS2000) were matched 1 : 1 with those given a countercurrent heat exchange warmer (Level-1 H-1000) based on propensity score. Matched variables included age, gender, body mass index, model for end-stage liver disease score, graft size and time under anesthesia. Core temperatures were taken at predetermined time points. RESULTS: Level-1 and FMS groups had comparable core temperature throughout the surgery from skin incision, the beginning/end of the anhepatic phase to skin closure. (P = 0.165, repeated measures ANOVA). The degree of core temperature changes within the dissection, anhepatic and postreperfusion phase were also comparable between the two groups. The minimum intraoperative core temperature was also comparable (Level 1, 35.6degrees C vs. FMS, 35.4degrees C, P = 0.122). CONCLUSIONS: A countercurrent heat exchange warmer and magnetic induction warmer displayed comparable function regarding the maintenance of core temperature and prevention of hypothermia during living donor liver transplantation. The applicability of the two devices in liver transplantation needs to be evaluated in various populations and clinical settings.

Alteraçäo da temperatura radicular externa durante o preparo para contençäo intra-radicular / Temperature changes on the external root during post space preparation

O objetivo deste trabalho foi comparar in vitro a alteraçäo de temperatura na superfície radicular externa durante o preparo para contençäo intra-radicular utilizando 4 técnicas de remoçäo da guta-percha: condensadores aquecidos, brocas de Peeso, Gates-Glidden e Largo, em 40 dentes pré-molares inferiores (unirradiculares) tratados endodonticamente. Experimento foi realizado em uma câmara com temperatura controlada em torno de 26ºC. Para a remoçäo da guta-percha do interior dos canais, foram calculados dois terços do comprimento da raiz, deixando em torno de 4 mm de obturaçäo apical. As mediçöes da temperatura radicular externa foram realizadas com um termopar acoplado a um multímetro e efetuadas em 3 regiöes: cervical (em torno de 3 mm abaixo da junçäo cemento-esmalte), média e apical...

Temperatura corpórea central durante e após garroteamento de membros inferiores em crianças / Central body temperature during and after tourniquet use on lower limbs of children

Justificativa e objetivos - garroeamento de membros inferiores, uni ou bilateral, durante anestesia, causa elevaçäo da temperatura corpórea em crianças, enquanto o desgarrotemento produz rápida reduçäo. No presente trabalho analisam-se comportamentos per e pós-isquêmicos da temperatura esofagiana ainda näo investigados: 1) evoluçäo durante garroteamento em crianças com paralisisa cerebral; 2) modificaçöes durante garroteamento bilateral sequencial; e 3) evoluçäo após desgarroteamento. Métodos - 66 crianças portadoras de sequelas de paralisisa cerebral, submetidas a intervençöes ortopédicas sob anestesia geral combinada à peridural sacra, foram divididas em quatro grupos: controle (I), garrote unilateral (II), bilateral simultâneo (III) e bilateral sequencial (IV). Sempre aplicou-se o garroteamento no terço superior da coxa. Temperatura corpórea (medida no esôfago inferior), foi registrada imediatamente após induçäo da anestesia e a cada 10 minutos no grupo-controle ou durante isquemia. Após o desgarroteamento foi determinada a cada dois minutos. Resultados - no grupo controle a temperatura elevou-se ligeiramente no início, mantendo-se estável. Com garroteamento elevou-se progressivamente em quase todos os pacientes, principalmente sob isquemia bilateral. Ocorreram diferenças significantes entre o grupo I e os demais grupos, entre os grupos II e III, entre grupos III e IV (1º) e IV (2º), quando considerados aos 60 minutos e 80 minutos de isquemia. Depois do desgarroteamento a temperatura corpórea central baixou rapidamente, atingindo níveis ligeiramente superiores aos pré-isquêmicos aos 20 minutos. Os resultados pós-isquêmicos obtidos nos grupos II, III e IV foram estatisticamente significantes aos 10 minutos e 20 minutos. Conclusöes - 1) garroteamento bilateral simultâneo em membros inferiores de crianças aumenta a temperatura esofagiana mais que o unilateral; 2) há rápida queda da temperatura esofagiana após o desgarroteamento; 3) crianças com garroeamento de membros devem ser aquecidas de forma cuidadosa e monitorizadas durante toda a intervençäo cirúrgica; 4) parece näo haver maior sensibilidade de crianças com sequelas de paralisia cerebral às variaçöes de temperatura central

Effects of Body Temperature Changes on Hypoxic Pulmonary Vasoconstriction in Isolated Lungs of Rabbits / 대한마취과학회지

BACKGROUND: We studied the effects of body temperature changes and repeated hypoxic stimulation on hypoxic pulmonary vasoconstriction (HPV). METHODS: We isolated lungs from 15 rabbits and perfused them at a constant flow of 30 ml/kg/min with a 3% albumin-physiologic salt solution containing autologous blood. After a 30-minute stabilization, the temperature of the perfusate was changed from 38oC to 32oC gradually. The lungs were ventilated for 15 minutes with a hyperoxic gas mixture consisting of 95% oxygen and 5% carbon dioxide and then for 5 minutes with a hypoxic gas mixture consisting of 3% oxygen and 5% carbon dioxide with the balance being nitrogen. We repeated the hypoxic stimulation 3 times at the same temperature. The mean pulmonary artery pressure changes and ventilation-related parameters were measured at each hypoxic stimulation. RESULTS: With the first hypoxic stimulation, the hypoxic pressure response at the end of the 5-minute hypoxic period decreased significantly at 32oC. With the second and the third hypoxic stimulations, the hypoxic pressure responses at the end of the 5-minute hypoxic period decreased significantly at both 34oC and 36oC. With repeated hypoxic stimulations, the hypoxic pressure responses potentiated significantly at all temperatures. The baseline mean pulmonary artery pressure increased significantly below 34oC. CONCLUSION: The HPV decreased with the reduction in body temperature and was potentiated by repeated intermittent hypoxia; also, the pulmonary vascular resistance increased with the reduction in the body temperature.

El posoperatorio inmediato en neurocirugía craneana / Initial postoperative care after cranial neurosurgery

La valoración previa del riesgo anestésico quirúrgico y la prevención de las complicaciones constituyen estrategias claves de la anestesia. La primera hora del postoperatorio neuroquirúrgico representa un período crítico en el cual pueden desarrollarse complicaciones que comprometan la vida del paciente; la falta de recuperación de la conciencia, la hipotermia, alteraciones del medio interno y la dificultad respiratoria constituyen las principales. Se analiza la prevención, diagnóstico y tratamiento de las principales complicaciones postoperatorias en el paciente neuroquirúrgico. Se describen las causas anestésicas, quirúrgicas y fisiopatológicas de retraso en el despertar.

El posoperatorio inmediato en neurocirugía craneana / Initial postoperative care after cranial neurosurgery

La valoración previa del riesgo anestésico quirúrgico y la prevención de las complicaciones constituyen estrategias claves de la anestesia. La primera hora del postoperatorio neuroquirúrgico representa un período crítico en el cual pueden desarrollarse complicaciones que comprometan la vida del paciente; la falta de recuperación de la conciencia, la hipotermia, alteraciones del medio interno y la dificultad respiratoria constituyen las principales. Se analiza la prevención, diagnóstico y tratamiento de las principales complicaciones postoperatorias en el paciente neuroquirúrgico. Se describen las causas anestésicas, quirúrgicas y fisiopatológicas de retraso en el despertar. (AU)

El uso del signo de Benjamín en el diagnóstico precoz de la endometriosis / Use of Benjamin's sign in the early diagnosis of endometriosis

Se analizan las razones que existen para usar el signo de Benjamín (persistencia de la temperatura basal del cuerpo elevada durante el período menstrual de la mujer) en el diagnóstico precoz de la endometriosis, especialmente en los grupos de menores de 25 años. En el grupo de 60 mujeres estudiado hay 40 por ciento menores de 25 años (13,4 por ciento menores de 20) y sexualmente inactivas 14, el 23,3 por ciento; 90 por ciento con dismenorrea importante y con signo de Benjamín + el 91,7 por ciento. Hubo 5 falsos negativos y 5 falsos positivos. La comprobación de la endometriosis se hizo mediante laparoscopía diagnóstico/quirúrgica pertinaz y progresiva, rebelde a tratamientos habituales con el objeto de hacer screening de candidatas a laparoscopía

A Study in the Comparison of Body Temperature Change between General Anesthesia and Epidural Anesthesia / 대한마취과학회지

BACKGROUND: Core hypothermia after induction of anesthesia results from an core-to-peripheral redistribution of body heat and a loss of body heat to environment. The purpose of this study is finding body temperatures during operation by either general of epidural anesthesia and evaluates content of total body heat. METHODS: We measured tympanic membrane temperature, 4 point skin temperature (mid calf, mid thigh, upper extremity, nipple). And we calculate mean skin temperature, mean body temperature, total body heat content changes based on tympanic membrane temperature and 4 point skin temperature. RESULTS: Tympanic membrane temperature of the first group decreased significantly after 10 minutes of induction (p<0.005), the second group decreased after 45 minutes of induction. Although upper extremity temperature has continuously increased as time passed, there was no significant difference in both group. Lower extremity temperature has significantly increased after 30 minutes of induction in the first group, and the second group has significantly increased after 10 minutes of induction (p<0.05). Mean skin temperature hasdecreasd temperaturily in both group after 10 minutes of induction and increased as time passed. Mean body temperature of the first group has significantly decreased after 10 minutes of induction (p<0.05) and second group has no significant changes. Total body heat content has continuously decreased after induction with no significance. CONCLUSIONS: General anesthesia reveals more significant decrease than epidural anesthesia. Both groups show significant decrease of body temperature after induction. We think that we need to close attention to temperature changes after induction for preventing possible side effects due to core hypothermia.

Cambios producidos por la edad en las respuestas cardiovasculares reflejas / Age induced changes on reflex elicited cardiovascular responses

Se estudio la influencia de la edad en las respuestas cardiovasculares reflejas al ortostatismo y a la maniobra de Valsalva en 105 sujetos adultos sanos, y la respuesta a la prueba presora al frío en 87 sujetos sanos, en un rango de edad comprendido entre 12 y 79 años, los cuales fueron estratificados por décadas para su análisis estadístico. Se incluyeron solamente sujetos sin evidencia de patología intercurrente y ninguno de los sujetos presentó obesidad no sobrepeso. La presión sistólica y diastólica (PAS y PAD) varió entre 113,6 ñ 4,2 y 64,2 ñ 2,9 mmHg respectivamente en el grupo 10-19 años de edad y 139,8 ñ 5,0 y 79,5 ñ 3,2 mmHg respectivamente en el grupo de 70-79 años de edad (X ñ ES). La frecuencia cardíaca en posición supina varió entre 71,2 ñ 3,2 lat/min en el grupo de 10-19 años y 75,8 ñ 3,0 lat/min en el grupo de 70-79 años de edad (X ñ ES). Respuesta al ortostatismo. El cambio de posición supina a la posición de pie aumento la presión media (PAM) en 10,0 ñ 1,25 mmHg en el grupo de 10-19 años; de esa edad en adelante, la respuesta de la población se hizo bimodal aumentando el porcentaje de personas que mostraban descenso de la PAM al ponerse de pie: 20 por ciento en el grupo de 50-59 años y 48 por ciento en el grupo de 70-79 años de edad. Los descensos de PA estuvieron en el rango de -5,3 ñ 0,6 a -12,6 ñ 1,4 mm g, y fueron asintomáticos. El mismo patrón se respuesta bimodal se observó en la frecuencia cardíaca. Prueba presora al frío. En el grupo de edad de 10-19 años, se produjo un aumento de la PAS y PAD de 17,6 ñ 5,0 mmHg respectivamente, patrón de respuesta que se mantuvo hasta el rango de edad de 40-49 años. A partis de la década de 50-59 años, la elevación de PAS y PAD se redujo desde 50 por ciento hasta 63 por ciento en las décads de 60-69 y 70-79 años de edad, sin desaparición total de la respuesta. El retorno de la PAS y PAD a los niveles de pre-estimulación fue normal en todos los grupos. Maniobra de Valsalva. Esta maniobra produjo una taquicardia que comenzó a los 5 segundos de iniciarse ésta, la cual llegó a un máximo de 40 por ciento sobre la frecuencia cardíaca basal hasta el intervalo de 40-49 años de edad. De los 50-59 años de edad en adelante la taquicardia máxima disminuyó significativamente siendo de 18 por ciento en el grupo de 60-69 años y 12 por ciento en el grupo de 70-79 años. La bradicardia inducida por descarga vagal que ocurre con el retorno a la respiración normal, desapareció totalmente en los dos grupos de edad antes mencionados. Posiblemente la atenuación de las respuestas reflejas a la maniobra de Valsalva y a la prueba presora al frío, así como los descensos de presión observados con el ortostatismo se relacionan con una menor reactividad de las fibras musculares lisas vasculares, menor reactividad del marcapaso sino-auricular a las catecolaminas y menor distensidad del ventrículo izquierdo con el aumento de la edad

Patología ginecoobstétrica y vuelo / Gynecologic-obstetric pathology and flight

The changes in fisiologic parameters during flight are discussed in regard to the mother and fetus. The risk and indications for Aeromedical Evacuation are analysed

Body Core Temperature Change after Pneumatic Tourniquet Release during Inhalation Anesthesia / 대한마취과학회지

The tourniquet is usually applied for the orthopedic surgeries on the lower extemity to obtain the bloodless surgical field and to reduce blood loss.However, there are various complications such as nerve and tissue damage from compression, hemodynamic changes, and metabolic changes from ischemia after applieation of the tourniquet. Release of the tourniquet with reperfusion of the lower limb results in transient core body temperature change and other important hemodynamic, respiratory, and metabolic changes. I observed the mild core temperature drop following the release of the tourniquet at the surgical procedure of the lower extremity during inhalation anesthesia. The results were as follows ; The mean drop in temperature of 0.5 degree (about 11.9 min ; mean) was observed following the tourniquet release. Compared with the baseline value, the decreases in temperature at 8, 10 and 15 min, were statistically significant. There was significant correlation between the duration of tourniquet application and temperature drop (r= 0.293).