Korean J Adult Nurs.  2018 Apr;30(2):206-215. 10.7475/kjan.2018.30.2.206.

Effects of Heated-Humidified Anesthetic Gas in the Elderly Patients with Colorectal Cancer during Laparoscopic Surgery: Randomized Controlled Trial

• Park HS
• Kang Y

• KMID: 2411823
• DOI: http://doi.org/10.7475/kjan.2018.30.2.206

Abstract

PURPOSE
This study aimed to evaluate effects of heated-humidified anesthetic gas on body temperature, acid-base balance, blood cortisol, and lymphocyte in the elderly patients with colorectal cancer during laparoscopic surgery.
METHODS
This study utilized an experimental design with a randomized controlled trial. A total of 60 patients with colorectal cancer were randomly assigned to one of two groups: either to the heated-humidified anesthetic gas group or to the usual anesthetic gas group. The following variables were measured: body temperature, acid-base balance, blood cortisol, and lymphocyte. The data were analyzed with independent t-test, χ2 test, ANCOVA, and repeated ANOVA using SPSS/WIN 20.0.
RESULTS
There was a significant difference in body temperature between the experimental group and the control group during laparoscopic surgery (F=41.18, p < .001). However, no statistically significant differences were found in acid-base balance, blood cortisol, and lymphocyte between two groups.
CONCLUSION
In this study, the body temperature during laparoscopic surgery was more effectively maintained with the heated-humidified anesthetic gas compared with the regular anesthetic gas. Therefore, the heated-humidified anesthetic gas might be considered to maintain the body temperature during laparoscopic surgery especially in the elderly population.

MeSH Terms

Acid-Base Equilibrium
Aged*
Anesthesia
Body Temperature
Colorectal Neoplasms*
Humans
Hydrocortisone
Laparoscopy*
Lymphocytes
Research Design
Hydrocortisone

Figure

• 

  Figure 1. Differences in body temperature between experimental group and control group.

Reference

1. Statistics Korea. Population projections for Korea (2015~2065) [Internet]. Seoul: Statistics Korea;2016. [cited 2018 April 09]. Available from:. http://kostat.go.kr/portal/korea/kor_nw/2/1/index.board?bmode=read&bSeq=&aSeq=357935&pageNo=1&rowNum=10&navCount=10&currPg=&sTarget=title&sTxt=%EC%9E%A5%EB%9E%98%EC%9D%B8%EA%B5%AC%EC%B6%94%EA%B3%84. http://kostat.go.kr/portal/korea/kor_nw/2/1/index.board?bmode=read&bSeq=&aSeq=357935&pageNo=1&rowNum=10&navCount=10&currPg=&sTarget=title&sTxt=%EC%9E%A5%EB%9E%98%EC%9D%B8%EA%B5%AC%EC%B6%94%EA%B3%84.

2. Jung KW, Won YJ, Oh CM, Kong HJ, Lee DH, Lee KH, et al. Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2014. Cancer Research and Treatment. 2017; 49(2):292–305. https://doi.org/10.4143/crt.2017.118.

3. Lee YS, Lee IK, Kang WK, Cho HM, Park JK, Kim JG. Laparoscopic surgery for colorectal cancer in elderly patients. Journal of the Korean the Society of Coloproctology. 2007; 23(4):257–61. https://doi.org/10.3393/jksc.2007.23.4.257.

4. 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):826–33. https://doi.org/10.1213/01.ANE.0000048822.27698.28.

5. Cho EJ, Lee KS, Hong SJ. Comparison of core temperature changes during prolonged laparoscopic and open surgery. Korean Journal of Anesthesiology. 2007; 52(2):150–5. https://doi.org/10.4097/kjae.2007.52.2.150.

6. Kasai T, Hirose M, Yaegashi K, Matsukawa T, Takamata A, Tanaka Y. Preoperative risk factors of intraoperative hypothermia in major surgery under general anesthesia. Anesthesia and Analgesia. 2002; 95(5):1381–3. https://doi.org/10.1097/00000539-200211000-00051.

7. Cereda M, Maccioli GA. Intraoperative temperature monitoring. International Anesthesiology Clinics. 2004; 42(2):41–54. https://doi.org/10.1097/00004311-200404220-00005.

8. Cooper S. The effect of preoperative warming on patients' post-operative temperatures. AORN Journal. 2006; 83(5):1073–6. 1079-84.https://doi.org/10.1016/S0001-2092(06)60118-X.

9. Peng Y, Zheng M, Ye Q, Chen X, Yu B, Liu B. Heated and humidified CO2 prevents hypothermia, peritoneal injury, and intraabdominal adhesions during prolonged laparoscopic in-sufflations. Journal of Surgical Research. 2009; 151(1):40–7. https://doi.org/10.1016/j.jss.2008.03.039.

10. Kim MH, Park JJ, Lee MY, Kim GM, Jung MJ, Park SH, et al. A study on the effects of heated and humidified gas inhaled on patients' body temperature during and after surgery with general anesthesia. Journal of Korean Clinical Nursing Research. 2000; 6(1):115–27.

11. Kim SJ. Human physiology. Seoul: Medicine Books;2012.

12. Kilgour E, Rankin N, Ryan S, Pack R. Mucociliary function de-teriorates in the clinical range of inspired air temperature and humidity. Intensive Care Medicine. 2004; 30(7):1491–4. https://doi.org/10.1007/s00134-004-2235-3.

13. Frank SM, Raja SN, Bulcao C, Goldstein DS. Age-related ther-moregulatory differences during core cooling in humans. American Journal Regulatory Integrative and Comparative Physiology. 2000; 279(1):349–54. https://doi.org/10.1152/ajpregu.2000.279.1.r349.

14. Holden M, Makic MBF. Clinically induced hypothermia: why chill your patient? Advanced Critical Care. 2006; 17(2):125–32. https://doi.org/10.1097/00044067-200604000-00007.

15. Yi JW, Choi YK. The hemodynamic changes and stress hormone responses to mild intraoperative hypothermia during intravenous anesthesia in neurosurgical patients. Journal of Korean Prevention Medicine Public Health. 2003; 45(6):702–9. https://doi.org/10.4097/kjae.2003.45.6.702.

16. Kim JS. Anesthesia and temperature. Korean Journal of Anesthesiology. 2004; 47(5):609–16. https://doi.org/10.4097/kjae.2004.47.5.609.

17. Kurosawa S, Kato M. Anesthetic, immune cells, and immune responses. Journal of Anethesiolgy. 2008; 22(3):263–77. https://doi.org/10.1007/s00540-008-0626-2.

18. Kim MH, Kang YL. Effects of intraoperative hypothermia on the incidence of postoperative infection and responses of peripheral white blood cells. Korean Journal of Anesthesiology. 2002; 43(6):742–8. https://doi.org/10.4097/kjae.2002.43.6.742.

19. Park HS, Yoon HS. A comparison of the effects of intravenous fluid warming and skin surface warming on perioperative body temperature and acid base balance of elderly patients with abdominal surgery. Journal of Korean Academy of Nursing. 2007; 37(7):1061–72. https://doi.org/10.4040/jkan.2007.37.7.1061.

20. Park HG, Lim JS, Park JS, Joe JK, Lee S, Yon JH, et al. A comparative evaluation of humidifier with heated wire breathing circuit under general anesthesia. Korean Journal of Anesthesiology. 2009; 57(1):32–7. https://doi.org/10.4097/kjae.2009.57.1.32.

21. Ricard JD, Boyer A, Dreyfuss D. The effect of humidification on the incidence of ventilator-associated pneumonia. Respiratory Care Clinics of North America. 2006; 12(2):263–73.

22. Bae IL, Hur MH. The effects of intraoperative heated humidification on body temperature, blood pressure and shivering of patients undergoing general anesthesia. Journal of Korean Clinical Nursing. 2011; 17(2):192–203.

23. Park BJ, Park KH, Kim OJ. Fundamental manual for clinical researchers. Seoul: Ministry of Food and Drug Safety;2006.

24. Haynes SR, Lawler PG. An assessment of the consistency of ASA physical status classification allocation. Anesthesia. 1995; 50(3):195–9. https://doi.org/10.1111/j.1365-2044.1995.tb04554.x.

25. Lee GJ, Lee JN, Oh JW, Baek JH. Mid-term results of laparoscopic surgery and open surgery for radical treatment of colorectal cancer. Journal of the Korean Society of Coloproctology. 2008; 24(5):373–9. https://doi.org/10.3393/jksc.2008.24.5.373.

26. Kim DS. Basics Q & A for anesthesia residents. Seoul: Goonja Books;2007.

27. Faul F, Erdfelder E, Lang AG, Buchner A. G*Power3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods. 2007; 39(2):175–91. https://doi.org/10.3758/bf03193146.

28. Ginsberg S, Solina A, Papp D, Krause T, Pantin E, Scott G, et al. A Prospective comparison of three heat preservation methods for patients undergoing hypothermic cardiopulmonary bypass. Journal of Cardiothoracic and Vascular Anesthesia. 2000; 14(5):501–5. https://doi.org/10.1053/jcan.2000.9489.

29. Morris RH, Wilkey BR. The effect of ambient temperature on patient temperature during surgery not involving body cavi-ties. Anesthesiology. 1970; 32(2):102–7. https://doi.org/10.1097/00000542-197002000-00003.

30. Frank SM, Higgins MS, Breslow MJ, Fleisher LA, Gorman RB, Sitzmann JB, et al. The catecholamine, cortisol, and hemodynamic responses to mild perioperative hypothermia: a randomized clinical trial. Anesthesiology. 1995; 82(1):83–93. https://doi.org/10.1097/00000542-199501000-00012.