JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (15) Citing Articles via Google Scholar Google Scholar Articles by Ikeda, T. Articles by Sato, S. Search for Related Content PubMed PubMed Citation Articles by Ikeda, T. Articles by Sato, S.

---

GENERAL ARTICLES

Less Core Hypothermia when Anesthesia Is Induced with Inhaled Sevoflurane Than with Intravenous Propofol

Takehiko Ikeda, MD^*, Daniel I. Sessler, MD^,,§,||, Mutsuhito Kikura, MD^*, Tomiei Kazama, MD^*, Kazuyuki Ikeda, MD, FRCA^*, and Shigehito Sato, MD^*

*Department of Anesthesiology and Intensive Care, Hamamatsu University School of Medicine, Hamamatsu, Japan; Outcomes Research^TM Group and Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, California; §Ludwig Boltzmann Institute for Clinical Anesthesia and Intensive Care; and ||Department of Anesthesia and General Intensive Care, University of Vienna, Vienna, Austria

Address correspondence and reprint requests to Dr. Takehiko Ikeda, Department of Anesthesiology and Intensive Care, Hamamatsu University School of Medicine, 3600 Handa-cho, Hamamatsu 431-3192, Japan. Address e-mail to tikeda{at}hama-med .ac.jp.

Hypothermia after the induction of anesthesia results initially from core-to-peripheral redistribution of body heat. Sevoflurane and propofol both inhibit central thermoregulatory control, thus causing vasodilation. Propofol differs from sevoflurane in producing substantial peripheral vasodilation. This vasodilation is likely to facilitate core-to-peripheral redistribution of heat. Once heat is dissipated from the core, it cannot be recovered. We therefore tested the hypothesis that the induction of anesthesia with IV propofol causes more core hypothermia than induction with inhaled sevoflurane. We studied patients undergoing minor oral surgery randomly assigned to anesthetic induction with either 2.5 mg/kg propofol (n = 10) or inhalation of 5% sevoflurane (n = 10). Anesthesia in both groups was subsequently maintained with sevoflurane and 60% nitrous oxide in oxygen. Calf minus toe skin temperature gradients <0°C were considered indicative of significant vasodilation. Ambient temperature and end-tidal concentrations of maintenance sevoflurane were comparable in each group. Patients in both groups were vasodilated throughout most of the surgery. Nonetheless, core temperatures in patients who received propofol were significantly lower than those in patients who received inhaled sevoflurane. These data support our hypothesis that even a brief period of vasodilation causes substantial redistribution hypothermia that persists throughout surgery.

Implications: Core temperatures in patients who received IV propofol were consistently lower than those in patients who received inhaled sevoflurane, although anesthesia was subsequently maintained with sevoflurane in nitrous oxide in both groups. This suggests that even a brief period of propofol-induced vasodilation during anesthetic induction causes substantial redistribution hypothermia that persists throughout surgery.

This article has been cited by other articles:

				T. Iwata, S. Inoue, M. Kawaguchi, M. Takahashi, T. Sakamoto, K. Kitaguchi, H. Furuya, and T. Sakaki Comparison of the effects of sevoflurane and propofol on cooling and rewarming during deliberate mild hypothermia for neurosurgery Br. J. Anaesth., January 1, 2003; 90(1): 32 - 38. [Abstract] [Full Text] [PDF]

				T. Ikeda, T. Kazama, D. I. Sessler, S. Toriyama, K. Niwa, C. Shimada, and S. Sato Induction of Anesthesia with Ketamine Reduces the Magnitude of Redistribution Hypothermia Anesth. Analg., October 1, 2001; 93(4): 934 - 938. [Abstract] [Full Text] [PDF]

				R. M. Powell and D. J. Buggy Ondansetron Given Before Induction of Anesthesia Reduces Shivering After General Anesthesia Anesth. Analg., June 1, 2000; 90(6): 1423 - 1427. [Abstract] [Full Text] [PDF]

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999