Abstract：
Hypothermia during obstetric spinal anaesthesia is a common and important problem, yet temperature monitoring is often not performed due to the lack of a suitable, cost-effective monitor. This study aimed to compare a noninvasive core temperature monitor with two readily available peripheral temperature monitors during obstetric spinal anaesthesia. We undertook a prospective observational study including elective and emergency caesarean deliveries, to determine the agreement between affordable reusable surface temperature monitors (Welch Allyn SureTemp® Plus oral thermometer and the Braun 3-in-1 No Touch infrared thermometer) and the Dräger T-core© (using dual-sensor heat flux technology), in detecting thermoregulatory changes during obstetric spinal anaesthesia. Predetermined clinically relevant limits of agreement (LOA) were set at ± 0.5 °C. We included 166 patients in our analysis. Hypothermia (heat flux temperature < 36 °C) occurred in 67% (95% CI 49 to 78%). There was poor agreement between devices. In the Bland-Altman analysis, LOA for the heat flux monitor vs. oral thermometer were 1.8 °C (CI 1.7 to 2.0 °C; bias 0.5 °C), for heat flux monitor vs. infrared thermometer LOA were 2.3 °C (CI 2.1 to 2.4 °C; bias 0.4 °C) and for infrared vs. oral thermometer, LOA were 2.0 °C (CI 1.9 to 2.2 °C; bias 0.1 °C). Error grid analysis highlighted a large amount of clinical disagreement between methods. While monitoring of core temperature during obstetric spinal anaesthesia is clinically important, agreement between monitors was below clinically acceptable limits. Future research with gold-standard temperature monitors and exploration of causes of sensor divergence is needed.
摘要：
产科脊髓麻醉过程中的低体温是一个常见而重要的问题，然而，由于缺乏合适的温度监测，具有成本效益的显示器。这项研究旨在将产科脊髓麻醉期间的无创核心温度监测器与两个现成的周围温度监测器进行比较。我们进行了一项前瞻性观察性研究，包括选择性和紧急剖腹产，确定可重复使用的表面温度监测器（WelchAllynSureTemp®Plus口腔温度计和Braun3合1NoTouch红外温度计）与DrägerT-core©（使用双传感器热通量技术）之间的协议，在检测产科脊髓麻醉期间的体温调节变化。预先确定的临床相关的一致限度(LOA)设定在±0.5°C。我们在分析中纳入了166名患者。低体温（热通量温度<36°C）发生率为67％（95％CI49至78％）。设备之间的协议很差。在Bland-Altman分析中,热通量监测器的LOA与口腔温度计为1.8°C（CI1.7至2.0°C；偏置0.5°C），用于热通量监测器vs.红外温度计LOA为2.3°C（CI2.1至2.4°C；偏置0.4°C），红外与口腔温度计,LOA为2.0°C(CI1.9至2.2°C;偏置0.1°C)。误差网格剖析凸显了年夜量的临床分歧办法。虽然在产科脊髓麻醉期间监测核心温度在临床上很重要，监测员之间的一致性低于临床可接受的限度.需要使用金标准温度监测器进行未来研究，并探索传感器发散的原因。
