Central Temperature Changes Are Poorly Perceived during Epidural Anesthesia

Glosten, Beth; Sessler, Daniel I.; Faure, Eveline A. M.; Karl, Leah; Thisted, Ronald A.

doi:10.1097/00000542-199207000-00003

Cited by 85 publications

(40 citation statements)

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“…44,45 Further well-controlled prospective trials are needed to define the mechanisms, magnitude, and clinical relevance of epidural-associated maternal temperature disturbances.…”

Section: Commentmentioning

confidence: 99%

Effect of Epidural vs Parenteral Opioid Analgesia on the Progress of Labor

Halpern¹,

Leighton²,

Ohlsson³

et al. 1998

JAMA

280

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“…44,45 Further well-controlled prospective trials are needed to define the mechanisms, magnitude, and clinical relevance of epidural-associated maternal temperature disturbances.…”

Section: Commentmentioning

confidence: 99%

Effect of Epidural vs Parenteral Opioid Analgesia on the Progress of Labor

Halpern¹,

Leighton²,

Ohlsson³

et al. 1998

JAMA

280

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“…Although regional anesthesia typically causes core hypothermia, patients often feel warmer after induction of anesthesia [13,14]. Increased thermal comfort, like inhibition of autonomic defenses, presumably results from the thermoregulatory system mis-interpreting skin temperature as being elevated in the blocked area.…”

Section: The Impact Of Anesthesia On Thermoregulationmentioning

confidence: 99%

Hypothermia – it's more than a toy

Pestel

Kurz²

2005

Current Opinion in Anaesthesiology

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“…Therefore, shivering will stop in a cool environment after the onset of spinal anesthesia, even in the presence of a core temperature that has decreased by 1°C [13]. Patients under epidural anesthesia may report feeling warmest when their core temperature is at its lowest [14]. If a patient becomes sufficiently hypothermic during spinal or epidural anesthesia, shivering will occur cephalad to the block.…”

Section: Regional Anesthesia and Mechanisms Of Hypothermiamentioning

confidence: 99%

Managing perioperative hypothermia

Dhar

2000

Journal of Anesthesia

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surrounds this thermal core. The peripheral temperature ranges between 31° and 35°C, whereas skin temperature is generally 28° to 32°C [2,4]. The peripheral shell protects the thermal core by either absorbing heat from or releasing heat to the environment. The range of core temperatures that are tolerated without triggering a thermoregulatory response is known as the interthreshold range. This range is normally 0.2°C. Within this range, no autonomic responses to cold or warmth occur. Below the hypothermia threshold, vasoconstriction is triggered, followed by shivering as the temperature decreases further. Peripheral vasoconstriction takes place in arteriovenous shunts located primarily in the fingers and toes. These are controlled by centrally mediated α 1 -adrenergic receptors, but the vasoconstriction triggered by local hypothermia is augmented by α 2 -adrenergic receptors [3]. Shivering is an involuntary muscular activity that increases metabolic rate and oxygen consumption. The response to body temperatures above the hyperthermia threshold is perspiration.Reliable sites for monitoring the core temperature include the tympanic membrane, the nasopharynx, the distal esophagus, the rectum, and the pulmonary arteries. These reflect core temperature even during rapid cooling or rewarming [5]. The tympanic membrane temperature reflects that of the blood supplying the hypothalamus [6]. Measurement of temperature in the ear canal avoids the risk of tympanic membrane perforation. Esophageal probes are a popular means of temperature monitoring, and the results correlate well with tympanic membrane temperature [7]. It is important to note that the inspired air temperature affects the esophageal temperature and that the esophagus has a large temperature gradient along its length [8]. For investigative purposes, the esophageal probe is placed 12 to 16 cm distal to the best heart-lung sounds [9], but for clinical use it should be placed at the point of maximal heart sounds. Rectal probes have slow response rates and may give inaccurate readings.

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Central Temperature Changes Are Poorly Perceived during Epidural Anesthesia

Cited by 85 publications

References 0 publications

Effect of Epidural vs Parenteral Opioid Analgesia on the Progress of Labor

Effect of Epidural vs Parenteral Opioid Analgesia on the Progress of Labor

Hypothermia – it's more than a toy

Managing perioperative hypothermia

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