Physiologic Responses to Mild Perianesthetic Hypothermia in Humans

Sessler, Daniel I.; Rubinstein, Eduardo H.; Moayeri, Azita

doi:10.1097/00000542-199110000-00009

Cited by 242 publications

(114 citation statements)

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“…First, sufficient intraoperative hypothermia triggers thermoregulatory vasoconstriction [25,26]. Furthermore, vasoconstriction during recovery is universal in hypothermic patients because brain anesthetic concentration decreases rapidly, allowing re-emergence of thermoregulatory responses [27]. Thermoregulatory vasoconstriction decreases subcutaneous oxygen tension in humans [28], and the risk of wound infection correlates with subcutaneous oxygen tension [29,30].…”

Section: Hypothermia Reduces Host Defensementioning

confidence: 99%

Non-pharmacologic Prevention of Surgical Wound Infection

Sessler

2006

Anesthesiology Clinics of North America

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Wound infections are serious and relatively common postoperative complications. They are generally detected five to nine days after surgery and are usually attributed, even by surgeons, to poor surgical technique or failure to maintain sterility. However, it has been known for decades that all wounds become contaminated, often by bacteria from the skin or within the patient, and that it is host defense mechanisms that prevent most contamination from developing into clinical infections. Host defense is especially important during the initial hours following contamination, i.e., the immediate perioperative period.As might thus be expected, factors that improve host defense reduce infection risk. Many of these are under the direct control of anesthesiologists and are at least as important as appropriate use of prophylactic antibiotics, which halve infection risk [1]. This article will review nonpharmacologic methods of reducing infection risk, with special emphasis on methods available to anesthesiologists.

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Section: Hypothermia Reduces Host Defensementioning

confidence: 99%

Non-pharmacologic Prevention of Surgical Wound Infection

Sessler

2006

Anesthesiology Clinics of North America

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“…Shivering thermogenesis occurs in almost all hypothermic individuals after anesthesia but thermoregulation is only part of the etiology of postanesthetic clonus. Sessler and colleagues 16 have shown that spontaneous ankle clonus occurs commonly in hypothermic adults at isoflurane concentrations of between 0.5% and 0.1%, but flexion-induced clonus may occur at end-tidal isoflurane concentrations as high as 0.7%, and in normothermic individuals. Ankle clonus is but one of several signs of motor neuron hyperexcitability that have been variously described as "shakes", "spasticity" and "shivering".…”

Section: Me Et Th Ho Od Ds Smentioning

confidence: 99%

The ankle clonus test is not a clinically useful measure of spinal cord integrity in children

Ewen

Cox

Davies

et al. 2005

Can J Anesth/J Can Anesth

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P Pu ur rp po os se e: : Bilateral flexion-induced ankle clonus has been proposed as a test of spinal cord integrity during anesthesia for scoliosis surgery. The purpose of this study was to establish the reliability of this test in normal children emerging from volatile anesthesia. A secondary objective was to determine if there was a difference in the validity of this test with either sevoflurane or isoflurane anesthesia. M Me et th ho od ds s: :In a randomized, prospective blinded clinical trial, 32 healthy children aged three to 13 yr, were randomized to receive either isoflurane (Group I, n = 15) or sevoflurane (Group S, n = 17) for maintenance of anesthesia during dental restorative surgery. During emergence, an observer, blinded to group allocation, recorded ankle clonus scores (number of beats to a maximum of 5 on each side) at 60-sec intervals until tracheal extubation. End-tidal anesthetic concentration was measured contemporaneously.

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“…~2 The tympanic membrane shares the same CAN J ANAESTH 1996 / 43:12 /pp 1224-8 vascular supply that perfuses the hypothalamus and is an excellent, readily accessible site 13 and tympanic membrane temperature is considered to be the most reliable core temperature in clinical practice) 4 Four infrared tympanic thermometers [(Genius | , Sherwood IMS, Inc., CA, USA), (Thermopit | Nipro, Inc., Osaka, Japan), (Quickthermo| Omron Inc., Mie, Japan), and (Thermoscan| Thermoscan, Inc., CA, USA)] are commercially available in Japan. Each thermometer is a small, battery-operated unit, and consists of an otoscope-like probe (covered by disposable cellophane) that is introduced into the outer third of the auditory canal.…”

Section: Objectif" Comparer Les Mesures Obtenues De Quatre Thermom~trmentioning

confidence: 99%

A comparison of four infrared tympanic thermometers with tympanic membrane temperatures measured by thermocouples

et al. 1996

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TM (r = 0.56, 0.63, and 0.58, respectively). Mean differences between TM and each temperature (TG, 7"re, T9_, 0.73, 0.42, 0.37, 0.35, and 0.35. Key wordsEQUIPMENT: thermometers; thermocouples; TEMPERATURE: core temperature, measurement, tympanic membrane temperature. Tm (respectivement r = 56, r = 0,63 et r = 0,58). La diffgrence moyenne respective entre TM et chaque tempgrature (TG, TTt',3, 0,73, 0,3~ Dans le m~me ordre, l'~cart type ~tait de 0,33, 0,37, 0,35 et 0,35 Core temperature perturbations are common in the perioperative period ~ and may indicate underlying problems such as malignant hyperthermia 2 and inadvertent hypothermia. 3 Furthermore, thermal disturbances are associated with numerous complications 4-9 and should be appropriately treated, t~ Consequently, core temperature monitoring is a critical aspect of anaesthesia practice. There are various sites for core temperature measurement such as rectal, bladder, oesophageal, and tympanic membrane. ~2 The tympanic membrane shares the same CAN J ANAESTH 1996 / 43:12 /pp 1224-8

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Physiologic Responses to Mild Perianesthetic Hypothermia in Humans

Cited by 242 publications

References 0 publications

Non-pharmacologic Prevention of Surgical Wound Infection

Non-pharmacologic Prevention of Surgical Wound Infection

The ankle clonus test is not a clinically useful measure of spinal cord integrity in children

A comparison of four infrared tympanic thermometers with tympanic membrane temperatures measured by thermocouples

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