Abstract
ObjectiveThis study aims to observe the impact of the temperature of blood transfusion and infusion toward the perioperative cerebral oxygen metabolism and the postoperative cognitive recovery.MethodsEighty patients of knee replacement under epidural and general anesthesia were randomly divided into warming blood transfusion and infusion (WBI) group (n = 40) and control group (n = 40). The changes of nasopharyngeal temperature, middle cerebral artery blood flow, CERO2, and SjVO2 of the two groups were recorded at each time point for the assessment of the postoperative overall quality of recovery and cognitive recovery situation.ResultsThe nasopharyngeal temperatures of the two groups at different time points after transfusion were significantly lower than that at T1, and there was a significant difference between the two groups (P < 0.05). The CERO2 values of the two groups at T3 were significantly higher than at T1, while the SjVO2 values were significantly decreased (P < 0.01).ConclusionThe WBI can significantly reduce the occurrence of the perioperative hypothermia, while it has no significant effect toward cerebral oxygen metabolism, postoperative overall recovery, and recovery of cognitive function.
Highlights
Postoperative neuropsychological dysfunction is a common complication in elderly patients after joint replacement surgery
In order to prevent the occurrence of hypothermia in patients, warming blood transfusion and infusion (WBI) is often clinically performed, and its benefits to the body have been reported in many relevant studies [10,11]
Comparison of general data between two groups There were no significant differences in age, sex, height, weight, operation time, extubation time, tourniquet time, blood loss, blood transfusion, or preoperative Post-operative Quality Recovery Scale (PQRS) baseline value between the two groups (Table 1)
Summary
Postoperative neuropsychological dysfunction is a common complication in elderly patients after joint replacement surgery. A lot of blood transfusion could cause the occurrence of intraoperative hypothermia, especially for the elderly patients. The perioperative hypothermia would increase the blood level of catecholamines in the circulation, resulting in the systemic vasoconstriction, which would increase the risk of cardiovascular complications. Ozaki [8] found that toward the patients who suffered from perioperative hypothermia, the infection rate of the postoperative wound was 6.3 times that that with normal body temperature. A meta-analysis [9] pointed out that the intraoperative mild hypothermia would increase the blood loss of the patient by about 16% and the relative risk of transfusion by 22%. In order to prevent the occurrence of hypothermia in patients, warming blood transfusion and infusion (WBI) is often clinically performed, and its benefits to the body have been reported in many relevant studies [10,11]
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