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REGIONAL ANESTHESIA AND PAIN MANAGEMENT

Temperature Monitoring Practices During Regional Anesthesia

Steven M. Frank, MD^*, Judy M. Nguyen, MD^*, Christine M. Garcia, MD^*, and Rachel A. Barnes, MS

*Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins Medical Institutions; and Medical Student, University of Maryland, Baltimore, Maryland

Address correspondence and reprint requests to Steven M. Frank, MD, Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins Hospital, Carnegie 442, 600 N. Wolfe St., Baltimore, MD 21287. Address e-mail to sfrank{at}welchlink.welch.jhu.edu

Monitoring and maintaining body temperature during the perioperative period has a significant impact on the risk of myocardial ischemia, cardiac morbidity, wound infection, surgical bleeding, and patient discomfort. To test the hypothesis that body temperature is inadequately monitored during regional anesthesia (RA), we randomly surveyed 60 practicing anesthesiologists to determine practice patterns for temperature monitoring. Only 33% of the clinicians surveyed routinely monitor body temperature during RA. Although skin temperature monitoring has limitations, it was the most commonly used method among the survey respondents. When temperature is monitored during RA, most clinicians use either liquid crystal skin-surface monitoring or axillary temperature probes. Of those surveyed, <15% use acceptable core temperature monitoring techniques (urinary bladder or tympanic membrane). In conclusion, it seems that body temperature is often not monitored in patients receiving RA.

Implications: The results of this survey of practicing anesthesiologists indicate that body temperature is often not monitored in patients receiving regional anesthesia. It is therefore likely that significant hypothermia goes undetected and untreated in these patients.

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