The effects of anesthetic technique and ambient temperature on thermoregulation in lower extremity surgery

Özer, Ayşe Belin; Tosun, Fadime; Demirel, İsmail; Unlu, Serap; Bayar, Mustafa Kemal; Erhan, Ömer Lütfi

doi:10.1007/s00540-013-1555-2

Cited by 6 publications

(4 citation statements)

References 19 publications

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“…Also, there is a possibility that the higher use of regional anaesthesia in women in our study played a role in increasing the incidence of shivering. Regional anaesthesia has been shown to be associated with less intraoperative thermoregulatory impairment but greater and persistent postoperative lower body impairment 16,17 . An additional mechanism potentially leading to higher risk of shivering in regional anaesthesia may be related to the greater use of opioids in general anaesthesia, although it should also be noted that, in our institution, intrathecal morphine is usually administered with spinal anaesthesia.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Patient Sex on the Incidence of Early Adverse Events in a Population of Elderly Patients

Conti

Ballo

Boccalini

et al. 2014

Anaesthesia and Intensive Care

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Patient sex is known to influence the response to general and regional anaesthesia and recovery after surgery. However, most studies come from analyses carried out on middle-aged patients. As most of the patients admitted to the post-anaesthesia recovery room in our institution are elderly, we took the opportunity to investigate the association between sex and incidence of early adverse events in this older population of patients after major surgery. Consecutive patients undergoing general, orthopaedic, urological and gynaecological surgery, admitted to the recovery room of our institution over a 15-month period, were retrospectively studied. The following adverse events were considered in the analysis: shivering, postoperative nausea and vomiting, hypotension and hypertensive responses, new arrhythmias requiring treatment, acute respiratory failure and desaturation. A total of 1347 patients (mean age 73.3±15.1 years, 61.4% women) were included. Women showed a higher incidence of shivering (relative difference +48%, P=0.0003), postoperative nausea and vomiting (+91%, P<0.0001), hypotension (+32%, P=0.044) and desaturation (+60%, P=0.0030) than men. The incidence of hypertensive response, arrhythmias and acute respiratory failure were not statistically significantly different. The findings of this exploratory study suggest that women have a higher risk of early postoperative adverse events even in a more elderly population.

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Section: Discussionmentioning

confidence: 99%

The Effect of Patient Sex on the Incidence of Early Adverse Events in a Population of Elderly Patients

Conti

Ballo

Boccalini

et al. 2014

Anaesthesia and Intensive Care

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“…These changes in thermoregulatory threshold are small in comparison with the changes induced by general anaesthesia which are usually around 2‐4°C . However, clinical studies comparing the effects of epidural anaesthesia and general anaesthesia on core temperature could not detect a difference in core temperature profile …”

Section: Thermoregulation During Neuraxial Blocksmentioning

confidence: 94%

Assessment of skin temperature during regional anaesthesia—What the anaesthesiologist should know

Hermanns

Werdehausen

Hollmann

et al. 2018

Acta Anaesthesiol Scand

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Body temperature homeostasis is accurately regulated by complex feedback-driven neuronal mechanisms, which involve a multitude of thermoregulatory pathways. Thus, core temperature is constantly maintained within a narrow range. As one of the most effective regulatory systems skin temperature is dependent on skin blood flow. Skin blood flow in turn is highly dependent on sympathetic activity. Regional anaesthesia leads to blockade not only of somatosensory and motor nerve fibres but also of sympathetic fibres. As a consequence, vasoconstrictor tonic activity is abrogated and a vasodilation leads to an increase in skin blood flow and temperature. The aim of this review was to summarize the general physiology of thermoregulation and skin temperature as well as the alterations during regional anaesthesia. The main focus was the usefulness of measuring skin temperature as an indicator of regional anaesthesia success. According to the available literature, assessment of skin temperature can indeed serve to predict success of regional anaesthesia. Hence, it is important to realize that relevant and reliable temperature increase is only seen in the most distal body parts, ie fingers and toes. More proximally, temperature changes are frequently small and inconsistent, which means that assessment of block levels is not possible by temperature measurement. Furthermore, relevant skin temperature increases will only be observed in patients, which are initially vasoconstricted. In conclusion, measurement of skin temperature represents a reliable and feasible diagnostic tool to assess and predict the success or failure of regional anaesthesia procedures, especially in patients in which sensory testing is impossible.

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“…These colder environments may accelerate transfer of heat from the patient in addition to initial redistribution and therefore may compound the degree of ΔBT. Warmer ambient room temperatures have been shown to reduce the incidence and severity of IPH in human and veterinary patients 5,7,17 …”

Section: Discussionmentioning

confidence: 99%

“…Warmer ambient room temperatures have been shown to reduce the incidence and severity of IPH in human and veterinary patients. 5,7,17 Total anaesthetic time and type of procedure have also been shown to result in an increased incidence of IPH in dogs. 1,8 Dogs undergoing anaesthesia for more than 60 minutes have been found to have a decrease in rectal temperature that is four times greater than dogs with an anaesthetic duration of less than 60 minutes.…”

Section: Discussionmentioning

confidence: 99%

Retrospective investigation of decreasing body temperature trends during anaesthesia in dogs

et al. 2023

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BackgroundHypothermia during the perianaesthetic period may lead to an increased risk of morbidity in veterinary patients. However, the timeline of the decrease in body temperature during general anaesthesia has been minimally investigated.MethodsAnaesthetic records of 1097 client‐owned dogs were examined. Change in body temperature (ΔBT = baseline temperature – time point temperature) was plotted over time for all dogs. The slope of ΔBT was calculated for each 15‐minute interval, and the magnitude of the largest ΔBT and the time point at which the largest ΔBT occurred were determined for each record.ResultsA rapid decline in ΔBT occurred from 0 to 15 minutes, a slower decline occurred from 15 to 60 minutes and a plateau occurred from 60 to 240 minutes. The largest ΔBT occurred at 75 (15–240) minutes from baseline, with a maximum ΔBT of –2.06°C (–0.06°C to –8.72°C).LimitationsThis is a retrospective study. As such, there were missing data points and potential confounding factors could not be controlled for.ConclusionsAnaesthetised dogs exhibited a distinct pattern of decrease in body temperature, with the most rapid reduction occurring within the first 15 minutes. The effects of procedures and anaesthetic agents on the timeline and pattern of heat loss warrant further investigation.

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The effects of anesthetic technique and ambient temperature on thermoregulation in lower extremity surgery

Abstract: There were no significant differences in thermoregulation among anesthetic techniques. Room temperature affected thermoregulation in Group GA.

Cited by 6 publications

References 19 publications

The Effect of Patient Sex on the Incidence of Early Adverse Events in a Population of Elderly Patients

The Effect of Patient Sex on the Incidence of Early Adverse Events in a Population of Elderly Patients

Assessment of skin temperature during regional anaesthesia—What the anaesthesiologist should know

Retrospective investigation of decreasing body temperature trends during anaesthesia in dogs

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