The Monitoring and Management of Chills and the Treatment of Analgesia and Sedation in TTM
The Monitoring and Management of Chills and the Treatment of Analgesia and Sedation in TTM
Perioperative anesthesia and incorrect
target temperature management(TTM) may cause postoperative chills, which will directly affect the
survival rate of patients.
Correct target temperature management (TTM) can
significantly reduce the probability of postoperative chills. For patients with
existing chills, it is recommended to standardize the evaluation of chills.
Based on accuracy and reliability of scoring, BSAS(bedside shiver
assessment scale) is recommended as a clinical evaluation tool for chills.
Clinicians should rely on the evaluation
results to develop a detailed treatment plan in time.
For patients who have received
intravascular hypothermia therapy in the early stage, the most recommended
anesthesia is non-drug therapy.
The key of treatment is to use the body
surface insulation device to help patients recover their body temperature, and
monitor the temperature change of patients in real time through the medical
temperature probe, so as to prevent the hyperthermia or hypothermia caused by
the later treatment.
For away, which does not have a
satisfactory effect of using the body surface insulation device alone to
control chills, it can be considered to combine with medication.
It is recommended to
give priority to the use of non-sedative drugs (such as magnesium, paracetamol,
etc.).
If
chills are still uncontrollable, consider using narcotic analgesics and
sedatives.
The analgesic and sedative treatments in
target temperature management can be referred to as follows:
For the target body temperature less than
36 ℃ in severe cases, recommended for soothing calm treatment.
The use of analgesic and sedative drugs may
or may not be appropriate for severe patients who maintain a normal body
temperature.
The use of muscle relaxants in hypothermic
therapy is obviously controversial, and long-term use is not recommended.