Body temperature, cutaneous heat loss and skin blood flow during epidural anaesthesia for emergency caesarean section
File(s)
OA Location
Author(s)
Mullington, CJ
Low, DA
Strutton, PH
Malhotra, S
Type
Journal Article
Abstract
It is not clear how converting epidural analgesia for labour to epidural anaesthesia for emergency caesarean section affects either cutaneous vasomotor tone or mean body temperature. We hypothesised that topping up a labour epidural blocks active cutaneous vasodilation (cutaneous heat loss and skin blood flow decrease), and that as a result mean body temperature increases. Twenty women in established labour had body temperature, cutaneous heat loss and skin blood flow recorded before and after epidural top‐up for emergency caesarean section. Changes over time were analysed with repeated measures ANOVA. Mean (SD) mean body temperature was 36.8 (0.5)°C at epidural top‐up and 36.9 (0.6)°C at delivery. Between epidural top‐up and delivery, the mean (SD) rate of increase in mean body temperature was 0.5 (0.5) °C.h−1. Following epidural top‐up, chest (p < 0.001) and forearm (p = 0.004) heat loss decreased, but head (p = 0.05), thigh (p = 0.79) and calf (p = 1.00) heat loss did not change. The mean (SD) decrease in heat loss was 15 (19) % (p < 0.001). Neither arm (p = 0.06) nor thigh (p = 0.10) skin blood flow changed following epidural top‐up. Despite the lack of change in skin blood flow, the most plausible explanation for the reduction in heat loss and the increase in mean body temperature is blockade of active cutaneous vasodilation. It is possible that a similar mechanism is responsible for the hyperthermia associated with labour epidural analgesia.
Date Issued
2018-12-01
Date Acceptance
2018-08-28
Citation
Anaesthesia, 2018, 73 (12), pp.1500-1506
ISSN
0003-2409
Publisher
Wiley
Start Page
1500
End Page
1506
Journal / Book Title
Anaesthesia
Volume
73
Issue
12
Copyright Statement
© 2018 Association of Anaesthetists. This is the peer reviewed version of the following article, which has been published in final form at https://onlinelibrary.wiley.com/doi/full/10.1111/anae.14454. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.
Sponsor
Obstetric Anaesthetists Association
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000449669200008&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Grant Number
N/A
Subjects
Science & Technology
Life Sciences & Biomedicine
Anesthesiology
anaesthesia techniques: epidural
body temperature
caesarean section
complications: hypothermia
regional blood flow
temperature measurement
OXYGEN-CONSUMPTION
VASODILATION
HUMANS
LABOR
ANALGESIA
VASOCONSTRICTION
VENTILATION
PREGNANCY
ELEVATION
DELIVERY
Publication Status
Published
Date Publish Online
2018-10-13