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Body temperature, cutaneous heat loss and skin blood flow during epidural anaesthesia for emergency caesarean section

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Mullington, 2018, Anaesthesia, Word copy of manuscript.docxAccepted version173.91 kBMicrosoft WordView/Open
Title: Body temperature, cutaneous heat loss and skin blood flow during epidural anaesthesia for emergency caesarean section
Authors: Mullington, CJ
Low, DA
Strutton, PH
Malhotra, S
Item 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.
Issue Date: 1-Dec-2018
Date of Acceptance: 28-Aug-2018
URI: http://hdl.handle.net/10044/1/79792
DOI: 10.1111/anae.14454
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/Funder: Obstetric Anaesthetists Association
Funder's Grant Number: N/A
Keywords: 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
anaesthesia techniques: epidural
body temperature
caesarean section
complications: hypothermia
regional blood flow
temperature measurement
Adolescent
Adult
Anesthesia, Epidural
Anesthesia, Obstetrical
Body Temperature
Body Temperature Regulation
Cesarean Section
Emergency Medical Services
Female
Humans
Pregnancy
Regional Blood Flow
Skin
Young Adult
Skin
Humans
Body Temperature
Anesthesia, Epidural
Anesthesia, Obstetrical
Cesarean Section
Body Temperature Regulation
Pregnancy
Regional Blood Flow
Adolescent
Adult
Emergency Medical Services
Female
Young Adult
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
Anesthesiology
1103 Clinical Sciences
1109 Neurosciences
Publication Status: Published
Open Access location: https://doi.org/10.1111/anae.14454
Online Publication Date: 2018-10-13
Appears in Collections:Faculty of Medicine