Postoperative hemodynamic and thermoregulatory consequences of intraoperative core hypothermia - 12/09/11
, Daniel I. Sessler, MD ⁎, a, b, †, Edith Narzt, MD a, b, , Amir Bekar, MD a, b, †, Rainer Lenhardt, MD a, b, , Guenther Huemer, MD a, b, §, Franz Lackner, MD a, b, 
Address correspondence to Dr. Sessler at the Thermoregulation Research Laboratory, University of California, San Francisco, CA 94143-0648, USA.Abstract |
Study Objective: To evaluate the postoperative hemodynamic and thermoregulatory consequences of intraoperative core hypothermia.
Design: Prospective, randomized clinical trial.
Setting: Operating room and postanesthesia care unit of a university hospital.
Patients: 74 healthy, ASA status I, II, and III patients (average age 58 yrs) undergoing elective colon surgery.
Interventions: Patients were randomly assigned to be kept normothermic or ≈2.5 °C hypothermic during surgery. Anesthesia was maintained with isoflurane, nitrous oxide, and fentanyl. Postoperatively, surgical pain was treated with patient-controlled analgesia (PCA) opioid.
Measurements and Main Results: An observer blinded to group assignment and core temperatures evaluated shivering, thermal comfort, surgical pain, heart rates (HRs), and blood pressures (BPs) during the first six postoperative hours. Morphometric characteristics, oxygen saturation, fluid balance, PCA-administered opioid, and visual analog pain scores were comparable in the two groups. Hypothermic patients felt uncomfortably cold during recovery, and their postoperative core temperatures remained significantly less than in the normothermic patients for more than four hours. Peripheral vasoconstriction and shivering were common in the hypothermic patients but rare in those kept normothermic. HRs and BPs were comparable in the two groups.
Conclusions: These data confirm that the effects of intraoperative hypothermia on postoperative HR and BP are modest in relatively young, generally healthy patients. In contrast, intraoperative hypothermia caused substantial postoperative thermal discomfort, and full recovery from hypothermia required many hours. Delayed return to core normothermia apparently resulted largely from postoperative thermoregulatory impairment.
Le texte complet de cet article est disponible en PDF.Keywords : Anesthesia: postoperative care, blood pressure, heart rate, shivering, thermoregulation, vasoconstriction
 | Supported in part by a grant from the Max Kade Foundation, New York, NY, and the Joseph Drown Foundation, Los Angeles, CA, and National Institutes of Health Grant GM49670. The authors do not consult for, accept honoraria from, or own stock or stock options in any anesthesiarelated company. |
| Presented in part at the Annual Meeting of the American Society of Anesthesiologists, San Francisco, October 15–19, 1994. |
Vol 7 - N° 5
P. 359-366 - août 1995 Retour au numéro
- Use of esophageal or precordial stethoscopes by anesthesia providers: Are we listening to our patients?
- Richard C. Prielipp, Jeffrey S. Kelly, Raymond C. Roy
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?