Does Laminar Airflow in the Operating Room During Total Knee Arthroplasty Lead to More Perioperative Hypothermia Compared to Conventional Airflow?: A Randomized Clinical Trial

Year 2024, , 134 - 143, 27.08.2024

Recai Dağlı , Fatma Çelik , Mehmet Yetiş , Zafer Ünveren

https://doi.org/10.46332/aemj.1288834

Abstract

Purpose: Spinal anesthesia disrupts the body's thermoregulatory response, often leading to undesired perioperative hypothermia (<36ºC), especially in major surgeries such as total knee arthroplasty (TKA). In operating rooms with a laminar airflow system (LAS-OR), the airflow direction differs from conventional airflow systems (CAS-OR) by being directed directly onto the surgical table. The aim of this study is to answer the question, "Does laminar airflow in the operating room during total knee arthroplasty lead to more perioperative hypothermia compared to conventional airflow?"

Materials and Methods: This study is a prospective, randomized controlled trial. Patients were divided into two groups, Group L (operated in LAS-OR) (n=110) and Group C (operated in CAS-OR) (n=110), using simple randomization with sealed envelope method. The frequencies of perioperative hypothermia (IPH) were compared between the groups. (Clinical trial registration number/date: IRCT20180324039145N4 / 2018.10.31)

Results: In Group L, data from 94 patients and in Group C, data from 89 patients were evaluated. During TKA, the frequency of perioperative hypothermia (IPH) was 56.8% (104 out of 183 patients), with no statistical difference found between Group L and Group C (62.8% (59 out of 94 patients) vs. 50.6% (45 out of 89 patients), p=0.096). At the 105th minute, Group L experienced a temperature decrease of 0.76 (±0.47) ºC (95% CI: 0.61 to 0.91), whereas Group C had a temperature decrease of 0.74 (±0.51) ºC (95% CI: 0.58 to 0.90), with no significant difference observed (p=0.823).

Conclusion: There is no difference in the frequency of perioperative hypothermia (IPH) between operating rooms with laminar and conventional airflow during total knee arthroplasty under spinal anesthesia.

Keywords

intraoperative hypothermia, knee arthroplasty, laminar airflow, spinal anaesthesia, patient safety

Total Diz Artroplastisi Sırasında Ameliyathanedeki Laminar Havaakımı Klasik Havaakımından Daha Fazla Perioperatif Hipotermiye Neden Olur Mu? Randomize Klinik Araştırma

Abstract

Amaç: Spinal anestezi vücudun termoregülatuar yanıtını bozar, sıklıkla özellikle total diz artroplastisi (TKA) gibi major cerrahilerde istenmeyen perioperatif hipotermi (İPH) (<36ºC) gelişmesine neden olur. Laminar havaakım sistemli ameliyat odalarındaki (LAS-OR) hava akımının yönü, konvensiyonel havaakım sistemli ameliyat odalarındakinin (CAS-OR) aksine, doğrudan ameliyat masasına doğrudur. Bu araştırmadaki amacımız “ Total diz artroplastisi sırasında ameliyathanedeki laminar havaakımı klasik havaakımından daha fazla perioperatif hipotermiye neden olur mu?” sorusunu cevaplamaktır.

Araçlar ve Yöntem: Bu çalışma prospektif, randomize kontrollü bir araştırmadır. Hastalar grup L (LAS-OR’ da ameliyat edilenler) (n=110) ve grup C (CAS-OR’da ameliyat edilenler) (n=110) basit randomizasyonla, kapalı zarf metodu kullanılarak iki gruba ayrıldı. İPH frekansları karşılaştırıldı. (Clinical trial kayıt numarası/tarih: IRCT20180324039145N4 / 2018.10.31)

Bulgular: Grup L’de 94 hastanın grup C’de 89 hastanın verileri değerlendirildi. TKA sırasında İPH frekansı %56.8 ‘iken (183 hastanın 104’ünde), grup L ve grup C arasında istatiksel fark bulunmamıştır ( %62.8(94 hastanın 59’u) & %50.6 (89 hastanın 45’i), p=.096). Yüz beşinci dakikada, grup L’de 0.76 (±0.47) ºC (95%CI (0.61 to 0.91)) sıcaklık azalması varken buna karşı grup C’de 0.74 (±0.51) ºC ( 95%CI (0.58 to 0.90), p=.823) sıcaklık azalması bulunmuştur.

Sonuç: Spinal anestezi altında total diz artroplastisi sırasında laminar ve konvensiyonel hava akımlı odalardaki İPH frekansları arasında fark yoktur.

Keywords

diz artroplastisi, hasta güvenliği, intraoperatif hipotermi, laminar hava akımı, spinal anestezi

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