Intraoperative body temperature and emergence delirium in elderly patients after non-cardiac surgery:A secondary analysis of a prospective observational study

作     者：Guojun Wang Shuting He Mengyao Yu Yan Zhang Dongliang Mu Dongxin Wang 

作者机构：Department of AnesthesiologyPeking University First HospitalBeijing 100034China Department of AnesthesiologyPeking University Cancer HospitalBeijing 100142China 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2023年第136卷第19期

页      面：2330-2339页

核心收录：

学科分类：1002[医学-临床医学] 10[医学] 100217[医学-麻醉学] 

基　　金：supported by a grant from the National Key Research and Development Program of China(No.2018YFC2001800) 

主　　题：Hypothermia Hyperthermia Emergence delirium Pain measurement Cognitive dysfunction Non-cardiac surgery Aged Post-anesthesia care unit 

摘      要：Background:Emergence delirium(ED)is a kind of delirium that occured in the immediate post-anesthesia period.Lower body temperature on post-anesthesia care unit(PACU)admission was an independent risk factor of ED.The present study was designed to investigate the association between intraoperative body temperature and ED in elderly patients undergoing non-cardiac surgery.Methods:This study was a secondary analysis of a prospective observational study.Taking baseline body temperature as a reference,intraoperative absolute and relative temperature changes were calculated.The relative change was defined as the amplitude between intraoperative lowest/highest temperature and baseline reference.ED was assessed with the confusion assessment method for intensive care unit at 10 and 30 min after PACU admission and before PACU discharge.Results:A total of 874 patients were analyzed with a mean age of 71.8±5.3 years.The incidence of ED was 38.4%(336/874).When taking 36.0°C,35.5°C,and 35.0°C as thresholds,the incidences of absolute hypothermia were 76.7%(670/874),38.4%(336/874),and 17.5%(153/874),respectively.In multivariable logistic regression analysis,absolute hypothermia(lowest value1.0°C from baseline)and its cumulative duration were also associated with an increased risk of ED,respectively.When taking the relative increment0.5°C as a threshold,the incidence of relative hyperthermia was 21.7%(190/874)and it was associated with a decreased risk of ED after adjusting above confounders.Conclusions:In the present study,we found that intraoperative hypothermia,defined as either absolute or relative hypothermia,was associated with an increased risk of ED in elderly patients after non-cardiac surgery.Relative hyperthermia,but not absolute hyperthermia,was associated with a decreased risk of ED.Registration:Chinese Clinical Trial Registry(No.ChiCTR-OOC-17012734).