Korean J Anesthesiol.  2003 Jul;45(1):71-77. 10.4097/kjae.2003.45.1.71.

Core and Peripheral Temperature Changes with and without Wrapping the Lower Extremity during Open Abdominal Surgery under General Anesthesia

• Chung JY
• Kim HO
• Kim BI
• Cho SK
• Kim JK

• KMID: 2236742
• DOI: http://doi.org/10.4097/kjae.2003.45.1.71

Abstract

BACKGROUND: Core hypothermia after the induction of general anesthesia results largely from core-to- peripheral redistribution of body heat and anesthetic-induced inhibition of tonic thermoregulatory vasoconstriction. Because most metabolic heat is lost via the skin surface, covering the skin surface with an insulator is a way of minimizing heat loss. We therefore evaluated core and peripheral temperature changes with and without wrapping the lower extremity in cotton and elastic bandages during open abdominal surgery under general anesthesia.
METHODS
Eighty-five patients of ASA physical status 1 or 2 who underwent open abdominal surgery under general anesthesia were investigated in this study. They were randomly assigned based on wrapping of the lower extremity in cotton and elastic bandages (group 2, n = 37) or not (group 1, n = 48). Anesthesia in both groups was induced with propofol and maintained with enflurane and 50% nitrous oxide in oxygen. The temperatures of the nasopharynx, forehead, chest, back, palm and sole were measured before and 10, 30, 60, 90, 120, 150 and 180 min after induction.
RESULTS
Core temperature decreased significantly after the induction of anesthesia in both groups (P <0.05), but no significant difference was found between the groups in terms of core, palm, back and forehead skin temperature changes. However, the core and chest temperatures of group 2 at 150 and 180 min after induction were significantly lower than those of group 1 (P <0.05), and sole temperature changes were significantly different between the groups (P <0.05).
CONCLUSIONS
Wrapping the lower extremity in cotton and elastic bandages during open abdominal surgery under general anesthesia was not effective at preventing the core temperature from decreasing. It is possible that wrapping the lower extremity causes peripheral vasodilation before anesthesia, stimulating the barorecepter, and shifting the body core temperature threshold for hypothermia inducing peripheral vasoconstriction to lower the body core temperature.

Keyword

general anesthesia; temperature; wrapping the lower extremity

MeSH Terms

Anesthesia
Anesthesia, General*
Body Temperature Regulation
Compression Bandages
Enflurane
Forehead
Hot Temperature
Humans
Hypothermia
Lower Extremity*
Nasopharynx
Nitrous Oxide
Oxygen
Propofol
Skin
Skin Temperature
Thorax
Vasoconstriction
Vasodilation
Enflurane
Nitrous Oxide
Oxygen
Propofol