Heat Flow and Distribution during Epidural Anesthesia

Matsukawa, Takashi; Sessler, Daniel I.; Christensen, Richard M.; Ozaki, Makoto; Schroeder, Mark E.

doi:10.1097/00000542-199511000-00008

Cited by 276 publications

(124 citation statements)

References 30 publications

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“…A discreta redução da temperatura retal no decorrer do tempo pode ser atribuída à ação vasodilatadora e depressora dos mecanismos termorreguladores do hipotálamo e miorrelaxamento induzido pela acepromazina (HALL & CLARKE, 1991). Além disso, a anestesia epidural também pode ser prejudicial ao controle da termorregulação central e periférica, induzindo a ocorrência de hipotermia (MATSUKAWA et al, 1995). Ademais, durante a cirurgia, outros fatores facilitam a ocorrência da redução da temperatura corpórea, como exposição da cavidade abdominal, perda sanguínea e anestesia geral (CASSU et al, 2008).…”

Section: Resultsunclassified

Anestesia epidural cranial com lidocaína e morfina para campanhas de castração em cães

et al. 2009

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Section: Resultsunclassified

Anestesia epidural cranial com lidocaína e morfina para campanhas de castração em cães

et al. 2009

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“…Heat loss is greater during large than small surgeries, and greater heat deficits will develop during longer procedures (27,28). However, the duration of our survey was not long enough to observe this heat loss.…”

Section: Discussionmentioning

confidence: 82%

“…A decrease in temperature during anesthesia initially develops from a core-to-peripheral redistribution of body heat (26)(27)(28). Redistribution of core temperature is due to the fact that anesthetics inhibit the tonic vasoconstriction that normally maintains a large core-to-peripheral temperature gradient.…”

Section: Discussionmentioning

confidence: 99%

The effect of epidural and general anesthesia on newborn rectal temperature at elective cesarean section

Yentur

Topçu

Ekici

et al. 2009

Braz J Med Biol Res

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Both epidural and general anesthesia can impair thermoregulatory mechanisms during surgery. However, there is lack of information about the effects of different methods of anesthesia on newborn temperature. The purpose of this study was to determine whether there are differences in newborn rectal temperature related to type of anesthesia. Sixty-three pregnant women were randomly assigned to receive general or epidural anesthesia. Maternal core temperature was measured three times with a rectal probe just before anesthesia, at the beginning of surgery and at delivery. In addition, umbilical vein blood was sampled for pH. The rectal temperatures of the babies were recorded immediately after delivery, and Apgar scores were determined 1, 5, and 10 min after birth. The duration of anesthesia and the volume of intravenous fluid given during the procedure (833 ± 144 vs 420 ± 215 mL) were significantly higher in the epidural group than in the general anesthesia group (P < 0.0001). Maternal rectal temperatures were not different in both groups at all measurements. In contrast, newborn rectal temperatures were lower in the epidural anesthesia group than in the general anesthesia group (37.4 ± 0.3 vs 37.6 ± 0.3°C; P < 0.05) immediately after birth. Furthermore, the umbilical vein pH value (7.31 ± 0.05 vs 7.33 ± 0.01; P < 0.05) and Apgar scores at the 1st-min measurement (8.0 ± 0.9 vs 8.5 ± 0.7; P < 0.05) were lower in the epidural anesthesia group than in the general anesthesia group. Since epidural anesthesia requires more iv fluid infusion and a longer time for cesarean section, it involves a risk of a mild temperature reduction for the baby which, however, did not reach the limits of hypothermia.

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“…Last, there is altered thermoregulation under the central neuraxial block, characterized by a decrease in shivering thresholds. [17] Unfortunately it presents as a common perioperative problem causing hypertension, tachycardia and increase metabolic demands. Various risk factors associated with shivering include type and duration of anaesthesia, level of sensory blockade, age of patient, and temperature of operating room and infusion fluids.…”

Section: Discussionmentioning

confidence: 99%

Comparison of clonidine and tramadol for the control of shivering under spinal anaesthesia

Attal¹,

Chhaya²,

Singh³

et al. 2015

Int J of Biomed & Adv Res

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Objectives: This study aimed to evaluate the relative efficacy of intravenously administered clonidine and tramadol for control of intraoperative shivering following spinal anaesthesia. Materials and Methods: A prospective, randomized, clinical controlled study was conducted on 60 ASA grade-I &II patients of either sex, aged 18-40 years, scheduled for elective lower abdominal and lower limb surgeries, under spinal anaesthesia. Patients who developed post spinal intraoperative shivering of grades 3 or 4, lasting for minimum period of 2minutes were included in the study, and randomly allocated to one of the two groups, group C (n=30), received Inj. clonidine 50µg i.v., and group T (n=30), received Inj. tramadol 50mg i.v. when shivering was observed. Time taken for control of shivering, response rate, recurrence rate, and side effects were observed. Results: The response rate was significantly higher in tramadol group than clonidine group at 1min, 2mins, and 3mins and 5mins intervals and comparable in both groups at 15 mins. The average time taken for disappearance of shivering was higher in clonidine group i.e. 5.76 ± 0.88mins as against 3.16 ± 0.84mins in tramadol group (P=0.038). Patients with incomplete response and recurrence were more in clonidine group. Side effects like hypotension, bradycardia, sedation and dry mouth were observed in clonidine group patients, and nausea and vomiting in tramadol group, but were controllable. Conclusion: Tramadol is better as compared to clonidine for control of intraoperative shivering under spinal anaesthesia due to rapid onset, higher response rate, lesser recurrence, lesser sedation and lesser hemodynamic alterations.

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Heat Flow and Distribution during Epidural Anesthesia

Cited by 276 publications

References 30 publications

Anestesia epidural cranial com lidocaína e morfina para campanhas de castração em cães

Anestesia epidural cranial com lidocaína e morfina para campanhas de castração em cães

The effect of epidural and general anesthesia on newborn rectal temperature at elective cesarean section

Comparison of clonidine and tramadol for the control of shivering under spinal anaesthesia

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