Abstract
SummaryAn observational clinical study to evaluate the effect of phenylephrine infusion on maternal temperatures during scheduled cesarean delivery under spinal anaesthesia was conducted in 40 ASA physical status II parturients. Following placement of spinal anesthesia, phenylephrine infusion was initiated at 40 μg/min and titrated to maintain mean arterial pressure within 20 percent of baseline. Maternal oral temperature, heart rate, and blood pressure were measured at baseline, spinal placement, every 10 minutes thereafter for 60 minutes. Phenylephrine dose received was documented every ten minutes. The range in maternal temperature change was 0.06–0.29°C. The lowest recorded temperature was 36.3°C. Decreased maternal temperature was associated with duration of anesthesia and cumulative phenylephrine dose in a univariate model (P<0.001 for all). The multivariable model showed an association between a greater decrease in maternal temperature with larger doses of phenylephrine being administered.
Highlights
Heat is stored in the body in two compartments: core and peripheral
A phenylephrine infusion was initiated at 40 μg per minute and titrated to maintain mean arterial pressure (MAP) within 20% of baseline throughout the case
Maternal temperature change was associated with baseline temperature, cumulative phenylephrine dose, and time (P
Summary
Heat is stored in the body in two compartments: core and peripheral. Normal core temperature averages 37°C with peripheral temperatures measuring 2°C cooler. The inability to maintain body temperature is attributed to cold ambient temperature and disruption of thermoregulatory responses [2,3]. Anesthetic agents affect perioperative hypothermia by lowering the hypothalamic thermoregulatory set point for shivering and by increasing core-. To-peripheral heat redistribution through vasodilation [2,3]. This redistribution component occurs to a large extent during the first hour following induction of anesthesia and is a major cause of hypothermia in short surgical procedures [4]
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