Mild Intraoperative Hypothermia Increases Duration of Action and Spontaneous Recovery ofVecuronium Blockade during Nitrous Oxide-Isoflurane Anesthesia in Humans

Heier, Tom; Caldwell, James E.; Sessler, Daniel I.; Miller, Ronald D.

doi:10.1097/00000542-199105000-00003

Cited by 259 publications

(91 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Vasoconstriction decreases the partial pressure of oxygen in tissue, which lowers the resistance to infection. 8 The other commonly known adverse effects of hypothermia include shivering, 9 prolonged duration of drug action, 10 coagulopathy, 11 myocardial ischemia and decreased resistance to surgical infections. 12 Perioperative warming has been shown to reduce perioperative complications.…”

Section: Introductionmentioning

confidence: 99%

The role of perioperative warming in surgery: a systematic review

et al. 2009

View full text Add to dashboard Cite

OBJECTIVE: The objective of this review was to systematically analyze the trials on the effectiveness of perioperative warming in surgical patients. METHODS:A systematic review of the literature was undertaken. Clinical trials on perioperative warming were selected according to specific criteria and analyzed to generate summative data expressed as standardized mean difference (SMD). RESULTS:Twenty-five studies encompassing 3,599 patients in various surgical disciplines were retrieved from the electronic databases. Nineteen randomized trials on 1785 patients qualified for this review. The no-warming group developed statistically significant hypothermia. In the fixed effect model, the warming group had significantly less pain and lower incidence of wound infection, compared with the no-warming group. In the random effect model, the warming group was also associated with lower risk of post-anesthetic shivering. Both in the random and the fixed effect models, the warming group was associated with significantly less blood loss. However, there was significant heterogeneity among the trials.CONCLUSION: Perioperative warming of surgical patients is effective in reducing postoperative wound pain, wound infection and shivering. Systemic warming of the surgical patient is also associated with less perioperative blood loss through preventing hypothermia-induced coagulopathy. Perioperative warming may be given routinely to all patients of various surgical disciplines in order to counteract the consequences of hypothermia. RESUMOOBJETIVO: O objetivo desta revisão é analisar sistematicamente os ensaios sobre a eficácia do aquecimento perioperatório em pacientes cirúrgicos. MÉTODOS:Uma revisão sistemática da literatura foi realizada. Ensaios clínicos sobre aquecimento perioperatório foram selecionados segundo critérios específicos e analisados para gerar dados sumativo expresso na diferença média padronizada (standardized mean difference, SMD). RESULTADOS:Vinte e cinco estudos englobando 3.599 pacientes de várias disciplinas de cirurgia foram obtidos a partir de bases de dados eletrônicas.Dezenove ensaios aleatórios em 1.785 pacientes qualificados para esta revisão. Nenhum grupo de aquecimento desenvolveu estatisticamente significativa hipotermia. No modelo de efeito fixo, grupo de aquecimento tiveram significativamente menos dor e menor incidência de infecção na ferida quando comparado com o grupo de não-aquecimento. No modelo de efeito aleatório, grupo de aquecimento também foi associado a um menor risco de tremores pós-anestesia. Em ambos os modelos de efeitos fixos e aleatórios, o aquecimento foi significativamente associado com menor perda de sangue. No entanto, houve significativa heterogeneidade entre os ensaios.CONCLUSÃO: O aquecimento perioperatório de pacientes cirúrgicos é eficaz na redução da dor pós-operatória ferida, infecção ferida, e tremores. O aquecimento sistêmico do paciente cirúrgico também está associado com menor perda de sangue no perioperatório prevenindo hipotermia e induzindo coagulopatia. O ...

show abstract

Section: Introductionmentioning

confidence: 99%

The role of perioperative warming in surgery: a systematic review

et al. 2009

View full text Add to dashboard Cite

show abstract

“…Such levels of hypothermia were obtained only after 45-60 min of active cooling. 7 It is unlikely that the transatlantic differences reported here are due to differences in the rate of distribution or elimination of vecuronium. Dose-response relationships depend on the initial concentration of the drug, and are relatively independent of disposition processes, unless these are very rapid.…”

Section: Discussionmentioning

confidence: 75%

Neuromuscular effects of vecuronium and neostigmine in Montreal and Paris

et al. 1994

View full text Add to dashboard Cite

The potency of vecuronium was reported to be greater in Montreal than (28,5 5:6,8 In 1969, Katz et al. ~ reported that the maximum blockade attained after a single dose of d-tubocurarine or sueeinylcholine was greater and the duration of action was longer in New York than in London. The study was performed before dose-response techniques became common practice in the evaluation of muscle relaxants, and before a standard mode of stimulation, the train-of-four, 2 was introduced into clinical use and research. L'intervalle entre l~njection et le bloc maximum dtait de (moyenne • ET) 3,9 5:1,3 min~ Paris et 4,5 + 1,3 min~ Montrdal (NS). La dur~e d'action, c'est-~-dire le temps entre l'injection de vEcuronium et la rdcupdration de 25%, dtait plus courte h ParisRecently, Fiset et al. 3 performed another transatlantic study, and compared the dose-response curves for vecuronium between Montl~al and Paris. In spite of similar demographic data in both centres and an identical anaesthetic and neuromuscular technique, the Paris doseresponse curve was shifted to the fight by 30%, that is, vecuronium was more potent in Montreal. The difference could not be explained by differences in age, sex, weight or body habitus, because these variables were similar in both cities. Disposition of the drug probably had little effect on these differences, because dose-response data are CAN J ANAESTH 1994 / 41: 10 / pp908-12

show abstract

“…The incidence of wound infections triples, hospital stay is prolonged by 20 % [70] , blood-loss and transfusion rates increase [97,103] and the risk for cardiac complications [28,30] quadruples. The metabolism of the majority of drugs is reduced, including typical anaesthetics such as propofol [75] and muscle relaxants such as vecuronium [40] and atracurium [75] . Consequently, mild perioperative hypothermia lengthens postoperative recovery -even when temperature is not a criterion for transfer [74] .…”

Section: Effects Of Mild Perioperative Hypothermiamentioning

confidence: 99%

Diagnosis, prevention and treatment of accidental and perioperative hypothermia

Brandt¹,

Mühlsteff

Imhoff³

2012

Biomedizinische Technik/Biomedical Engineering

View full text Add to dashboard Cite

Accidental hypothermia and its variant, perioperative hypothermia, is a rather common clinical phenomenon in patients. This is surprising because the negative effects on clinical outcomes are well described and effective patient-warming devices are available today. The aim of this paper is to describe the physiologic background of accidental and perioperative hypothermia, the clinical relevance and existing prophylaxis and treatment options. Patient warming techniques will be discussed in detail. Remaining technical and clinical challenges and the need for further research will be addressed. We will present existing guidelines and standards and analyse the impact of accidental and perioperative hypothermia on cost effectiveness.

show abstract

Mild Intraoperative Hypothermia Increases Duration of Action and Spontaneous Recovery ofVecuronium Blockade during Nitrous Oxide-Isoflurane Anesthesia in Humans

Cited by 259 publications

References 0 publications

The role of perioperative warming in surgery: a systematic review

The role of perioperative warming in surgery: a systematic review

Neuromuscular effects of vecuronium and neostigmine in Montreal and Paris

Diagnosis, prevention and treatment of accidental and perioperative hypothermia

Contact Info

Product

Resources

About