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REGIONAL ANESTHESIA AND PAIN MEDICINE

The Accuracy and Precision of Body Temperature Monitoring Methods During Regional and General Anesthesia

Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins Medical Institutions, Baltimore, Maryland

Address correspondence and reprint requests to Christine G. Cattaneo, MD, Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins Medical Institutions, Halsted 842, 600 N. Wolfe St., Baltimore, MD, 21287. Address e-mail to ccattaneo{at}jhmi.edu

We tested the hypotheses that accuracy and precision of available temperature monitoring methods are different between spinal anesthesia (SA) and general anesthesia (GA), and that patients receiving SA are at equal risk for hypothermia as those receiving GA. Patients scheduled for radical retropubic prostatectomy were enrolled. Either GA (n = 16) or SA (n = 16) was given according to patient and clinician preference. Temperatures were monitored with thermocouple probes at the tympanic membrane, axilla, rectum, and forehead skin surface. Tympanic temperatures were also measured with an infrared device, and forehead skin temperatures were monitored with two brands of liquid crystal thermometer strips. Accuracy and precision of these monitoring methods were determined by using tympanic membrane temperature, measured by thermocouple, as the reference core temperature (T_c). At the end of surgery, T_c was similar between SA (35.0 ± 0.1°C) and GA (35.2 ± 0.1°C) (P = 0.44). Accuracy and precision of each temperature monitoring method were similar between SA and GA. Rectal temperature monitoring offered the greatest combination of accuracy and precision. All other methods underestimated T_c. These findings suggest that patients receiving SA or GA are at equal and significant risk for hypothermia, and should have their temperatures carefully monitored, recognizing that most monitoring methods underestimate T_c.

Implications: Body temperature should be monitored during spinal anesthesia because patients are at significant risk for hypothermia. Rectal temperature is a valid method of measuring core temperature, whereas other methods tend to underestimate true core temperature.

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