Abstract
BackgroundSpinal tumor surgery usually involved long operation time, large area of soft tissue resection and long wound, and was prone to hypothermia during the operation. Therefore, actively promoting insulation and optimizing the intraoperative insulation program have great potential in reducing the incidence of hypothermia and reducing the incidence of postoperative complications. In this study, we compared patients who did not implement multi-mode nursing insulation program (MNIP) with those who implemented MNIP, observing and comparing clinical outcomes, and complications in both groups, with the aim of developing an optimal management plan for the preoperative, intraoperative, and postoperative periods, respectively.MethodsWe selected 2 periods of 1 year, before (n = 120 patients) and after MINP implementation (n = 120 patients). Data were collected on patient demographics, operative, perioperative details, temperature changes, anesthesia recovery effect, incidence of postoperative wound infection, length of hospital stay and complications. PS analyses were used for dealing with confounding bias in this retrospective observational study.ResultsAfter PS matching, the outcomes of 120 well-balanced pairs of patients were compared (No-MNIP vs MNIP). There was no significant difference concerning the satisfaction survey. The results indicated that the MNIP had better insulation effect at 90 min, 120 min, 150 min after anesthesia induction and after surgery. There were 16 cases of complications in the No-MNIP group and 5 cases in the MNIP group postoperative, which have significant statistical difference.ConclusionIn this study, the incidence of intraoperative hypothermia was effectively reduced by adopting the multi-mode insulation scheme, thus reducing the incidence of incision infection and shortening the length of hospital stay of patients.
Highlights
Spinal tumor surgery usually involved long operation time, large area of soft tissue resection and long wound, and was prone to hypothermia during the operation
The outcome measures for the study were as following: Temperature changes during surgery The rectal temperature was recorded after induction of anesthesia (T1), 30 min (T2), 60 min (T3), 90 min (T4), 120 min (T5), 150 min (T6), and 1 day after operation between the No-multimode nursing insulation program (MNIP) group and the MNIP group in (T7)
Results of propensity score-matched (PS) matching After PS matching, outcomes were compared for 80 well-balanced pairs of patients, respectively (No-MNIP group and MNIP group)
Summary
We compared patients who did not implement multimode nursing insulation program (MNIP) with those who implemented MNIP, observing and comparing clinical outcomes, and complications in both groups, with the aim of developing an optimal management plan for the preoperative, intraoperative, and postoperative periods, respectively. Primary spinal tumors are rare, accounting for about 4.6 to 8.8% of all bone tumors, and spinal metastases account for 50% of all bone metastases. Intractable pain, spinal instability and nerve compression are the most common symptoms of spinal tumor. 30% of patients with spinal tumor will seriously affect the quality of life, have paraplegia and even shorten the survival period.
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