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Anesth Analg 2004;98:111-115
© 2004 International Anesthesia Research Society

ANESTHETIC PHARMACOLOGY

Chronic Treatment with Antipsychotics Enhances Intraoperative Core Hypothermia

Akira Kudoh, MD, Hajime Takase, MD, and Tomoko Takazawa, MD

Department of Anesthesiology, Hirosaki National Hospital, Hirosaki, Japan

Address correspondence and reprint requests to Akira Kudoh, MD, Department of Anesthesiology, Hirosaki National Hospital, 1 Tominocho, Hirosaki 036-8545, Aomori, Japan.

Antipsychotics can induce hypothermia, but intraoperative temperature regulation in schizophrenic patients taking antipsychotics remains unclear. We investigated intraoperative temperature regulation and postoperative shivering in chronic schizophrenic patients receiving antipsychotics. We studied 30 schizophrenic patients and 30 control patients who underwent orthopedic surgery. Tympanic membrane temperatures (35.7°C ± 0.5°C, 35.6°C ± 0.5°C, 35.6°C ± 0.4°C, 35.5°C ± 0.4°C, 35.4°C ± 0.5°C, and 35.4°C ± 0.3°C) 15, 30, 45, 60, 75, and 90 min, respectively, after induction in schizophrenic patients were significantly (P < 0.001) lower than those (36.5°C ± 0.5°C, 36.4°C ± 0.5°C, 36.3°C ± 0.4°C, 36.2°C ± 0.5°C, 36.2°C ± 0.4°C, and 36.1°C ± 0.4°C) in control patients. Mean skin temperatures (31.1°C ± 0.4°C [P = 0.008], 31.1°C ± 0.3°C [P = 0.007], and 31.1°C ± 0.2°C [P = 0.006]) 60, 75, and 90 min, respectively, after induction in schizophrenic patients were significantly lower than those (31.5°C ± 0.3°C, 31.5°C ± 0.3°C, and 31.5°C ± 0.3°C) in control patients. Four of 30 schizophrenic patients and 7 of 30 control patients developed postanesthesia shivering. There were no significant differences within 1 h after tracheal extubation in tympanic membrane temperatures between patients who shivered and those who did not shiver. In conclusion, chronic schizophrenic patients were more hypothermic during anesthesia. The incidence of postanesthesia shivering was not significantly increased.

IMPLICATIONS: Antipsychotics inhibit autonomic thermoregulation. This is caused by decreased heat production, increased heat loss, and impaired central action at the hypothalamus. Thus, schizophrenic patients receiving antipsychotics may have impaired intraoperative temperature regulation.




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A. Kudoh
Perioperative Management for Chronic Schizophrenic Patients
Anesth. Analg., December 1, 2005; 101(6): 1867 - 1872.
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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 © 2004 by the International Anesthesia Research Society.