Effect Of Forced-air Warming Blanket On Inflammatory Factors And Cognitive Function In Elderly Patients Undergoing Laparoscopic Radical Operation Of Colon Cancer

Objectives To investigate the effects of different temperature forced-air warming blanket and conventional thermal insulation measures on intraoperative temperature changes,perioperative inflammatory factors and postoperative cognitive function in elderly patients undergoing laparoscopic radical operation of colon cancer.Methods The study selected randomized controlled trial.According to inclusion and exclusion criteria,90 elderly patients undergoing general anesthesia and laparoscopic radical operation of colon cancer in our hospital from September 2020 to September 2021were selected to this study.The patients were randomly divided into three groups:38℃forced-air warming blanket group（group A）,32℃forced-air warming blanket group（group B）and control group（group C）,with 30 people in each group.Patients in group A and group B were heated actively with forced-air warming blanket,and the temperature gears were set at 38℃and 32℃respectively.Patients in group C were not insulated by special methods.MAP,SPO₂,HR and core temperature of the three groups were recorded before anesthesia induction（T₁）,15 minutes after anesthesia（T₂）,30 minutes after anesthesia（T₃）,1 hour after anesthesia（T₄）,2 hour after anesthesia（T₅）and at the end of operation（T₆）.The postoperative shivering and anesthesia recovery of the three groups were recorded after operation.The levels of IL-6 and TNF-αin venous blood were detected one day before operation（D₀）,one day after operation（D₁）and seven days after operation（D₇）.The concentration of S100βprotein in venous blood was detected at D₀,30minutes after operation[D₀（T₇）]and D₁.The cognitive function of patients was evaluated by MMSE at D₀,D₃and D₇.SPSS25.0 software was used to process the data.Results 1 There was no significant difference in the basic situation and postoperative rest pain among the three groups（P>0.05）.There was no statistical difference in MAP,HR and SPO₂among the three groups（P>0.05）.2 Intraoperative temperature:There was no significant difference in core temperature between the three groups at T₁（P>0.05）.The core temperature of patients in three groups decreased at T_2-6（P<0.05）.The core temperature of group A was higher than group C at T_2-6,group B was higher than group C at T_3-6,and group A was higher than group B at T_3-6（P<0.05）.The rate of intraoperative hypothermia was 0 in group A,20%in group B and 80%in group C.The rate of hypothermia in group A was lower than that in group B and group C（P<0.05）.The rate of shivering was 0 in group A,6.7%in group B and 46.7%in group C.The rate of shivering in group A and group B were lower than that in group C（P<0.05）.3 Anesthesia recovery:The time from drug withdrawal to recovery of spontaneous breathing,the time from drug withdrawal to eye opening and the time from drug withdrawal to extubation in group A and B were shorter than those in group C（P<0.05）.4 Relevant biomarkers:There was no significant difference in the preoperative level of IL-6,TNF-αand S100βprotein at D₀（P>0.05）.Compared with D₀,the levels of IL-6 and TNF-αof the three groups at D₁and D₇increased（P<0.05）.The levels of IL-6 and TNF-αin group A and groud B were lower than those in group C at D₁and D₇（P<0.05）,and group A were lower than group B at D₁and D₇（P<0.05）.The S100βprotein level of the three groups increased at D₀（T₇）and D₁（P<0.05）.The level of S100βprotein in group A and group B were lower than group C at D₀（T₇）and D₁（P<0.05）,and group A was lower than group B at D₀（T₇）and D₁（P<0.05）.5Cognitive function:The MMSE score of group A decreased at D₃（P<0.05）and returned to the preoperative level at D₇（P>0.05）.The MMSE scores of patients in group B and group C decreased at D₃and D₇（P<0.05）.There was no significant difference in MMSE scores among the three groups at D₀（P>0.05）.MMSE scores of groups A was higher than that of group C at D₃and D₇（P<0.05）.The MMSE score of group B was higher than that of group C（P<0.05）,but lower than that of group A at D₇（P<0.05）.At D₃,the rate of POCD was6.7%in group A,13.3%in group B and 43.3%in group C.The rate of POCD in group A and group B was lower than that in group C（P<0.05）.There was no significant difference in the rate of POCD between group A and group B（P>0.05）.At D₇,the rate of POCD was0 in group A,6.7%in group B and 20.0%in group C.The rate of POCD in group A was lower than that in group C（P<0.05）.There was no significant difference in the rate of POCD between group B and group C（P>0.05）.Conclusion 1 Forced-air warming blanket is helpful to reduce the intraoperative inflammatory response of elderly patients undergoing laparoscopic radical operation of colon cancer and improve their early postoperative cognitive function.And the effect of38℃temperature gear is better than 32℃temperature gear.2 The application of forced-air warming blanket in elderly patients undergoing laparoscopic radical operation of colon cancer can effectively reduce the rate of perioperative hypothermia and postoperative shivering.And the 38℃temperature gear is better than the 32℃temperature gear for stabilizing the patient’s perioperative body temperature.Figure 5,Table 12,Reference 117...