THERMOREGULATORY RESPONSE THRESHOLDS DURING SPINAL-ANESTHESIA

被引:9
作者
KURZ, A
SESSLER, DI
SCHROEDER, M
KURZ, M
机构
[1] UNIV CALIF SAN FRANCISCO,DEPT ANESTHESIA,SAN FRANCISCO,CA 94143
[2] UNIV VIENNA,DEPT ANESTHESIA & INTENS CARE,A-1010 VIENNA,AUSTRIA
[3] WAEHRINGER GUERTEL,DEPT TRANSFUS MED,VIENNA,AUSTRIA
关键词
D O I
暂无
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Reportedly, during spinal anesthesia, the shivering threshold is reduced almost-equal-to 1-degrees-C but the vasoconstriction threshold remains normal. Such divergence between the shivering and vasoconstriction thresholds is an unusual pattern of thermoregulatory impairment and suggests that the mechanisms of impairment during regional anesthesia may be especially complex. Accordingly, we sought to define the pattern of thermoregulatory impairment during spinal anesthesia by measuring response thresholds. Seven healthy women volunteered to participate on two study days. On one day, we evaluated thermoregulatory responses to hypothermia and hyperthermia during spinal anesthesia; on the other day, responses were evaluated without anesthesia. Upper body skin temperature was kept constant throughout the study. The volunteers were warmed via the lower body and cooled by central venous infusion of cold fluid. The core temperatures triggering a sweating rate of 40 g.m-2.h-1, a finger flow of 0.1 mL/min, and a marked and sustained increase in oxygen consumption were considered the thermoregulatory thresholds for sweating, vasoconstriction, and shivering, respectively. Spinal anesthesia significantly decreased the thresholds for vasoconstriction and shivering, and the decrease in each was almost-equal-to 0.5-degrees-C. The range of temperatures not triggering thermoregulatory responses (those between sweating and vasoconstriction) was 0.9 +/- 0.6-degrees-C during spinal anesthesia. The synchronous decrease in the shivering and vasoconstriction thresholds during spinal anesthesia is consistent with thermoregulatory impairment resulting from altered afferent thermal input.
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页码:721 / 726
页数:6
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