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Anesth Analg 2000;90:456
© 2000 International Anesthesia Research Society

GENERAL ARTICLES

Predictive Variables of Hypothermia in the Early Phase of General Anesthesia

Michiaki Yamakage, MD, PhD, Yasuhiro Kamada, MD, Yasuyuki Honma, MD, PhD, Naoki Tsujiguchi, MD, and Akiyoshi Namiki, MD, PhD

Department of Anesthesiology, Sapporo Medical University School of Medicine, Sapporo, Japan

Address correspondence and reprint requests to Michiaki Yamakage, MD, PhD, Department of Anesthesiology, Sapporo Medical University School of Medicine, South 1, West 16, Chuo-ku, Sapporo, Hokkaido 060-8543, Japan. Address e-mail to yamakage{at}sapmed.ac.jp

Core temperature decreases precipitously for 1 h and then decreases slowly for 2–3 h after the induction of general anesthesia. We investigated the predictive variables of hypothermia by measuring peripheral skin temperature and total body fat (TBF). We studied 60 adult patients who required general anesthesia with isoflurane. The following variables were measured preoperatively: right palmar skin temperature by using an infrared thermometer and skin thickness at arm and scapula by using a standard caliper. TBF was calculated by using the regression equation of Durnin and Womersley. Rectal temperature, taken to represent core temperature, was measured during the operation. The gradient of hypothermia induced by general anesthesia was divided into two parts: 1) a precipitous decrease for the first hour and 2) a slow decrease for the following 2–3 h. Preoperative palmar skin temperature had a significant linear relationship with the precipitous decrease in temperature over the first hour (r = 0.69, P < 0.0001), and TBF had a significant linear relationship with the subsequent slow decrease in temperature (r = 0.63, P < 0.0001). By simple measurements, we can predict the extent of hypothermia in the early phase of general anesthesia and prevent its onset by using body-warming techniques.

Implications: After the induction of general anesthesia, palmar skin temperature had a linear relationship with the precipitous decrease in rectal temperature over the first hour, and total body fat had a linear relationship with the subsequent decrease in temperature. Thus, by simple measurements, we can predict the extent of hypothermia in the early phase of general anesthesia.






Lippincott, Williams & Wilkins 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 HighWire Press
Copyright © 2000 by the International Anesthesia Research Society.