The thermoregulatory threshold in infants and children anesthetized with isoflurane and caudal bupivacaine. 1990

B Bissonnette, and D I Sessler
Department of Anaesthesia, Hospital for Sick Children, Toronto, Ontario, Canada.

Hypothermia in anesthetized adults provokes centrally mediated, peripheral thermoregulatory vasoconstriction at threshold temperatures approximately 2.5 degrees C below normal. The weight dependence of thermoregulatory vasoconstriction was evaluated in 33 unpremedicated pediatric patients receiving isoflurane/oxygen anesthesia (end-tidal concentrations approximately 0.9%) and caudal anesthesia with bupivacaine. The patients were prospectively assigned to four weight groups (5-10 kg, 10-20 kg, 20-30 kg, and 30-50 kg). Central temperature was measured at the tympanic membrane, and average skin surface temperature was determined from four cutaneous sites; mean body temperature was calculated from central and average skin temperatures. Finger blood flow was determined using laser Doppler flowmetry and forearm-fingertip skin temperature gradients. Significant peripheral vasoconstriction was prospectively defined as a laser Doppler flow index 50% of the value recorded 10 min after induction of anesthesia. Thermoregulatory thresholds were defined as the tympanic membrane or mean body temperatures at which significant vasoconstriction occurred. Vasoconstriction occurred in 32 of the patients at temperatures ranging from 34.4 to 35.3 degrees C. Central and mean body threshold temperatures did not differ among the groups, and were similar to those observed previously in adults. There was a good correlation between laser Doppler flowmetry and forearm-fingertip skin temperature gradients in individual patients.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D007530 Isoflurane A stable, non-explosive inhalation anesthetic, relatively free from significant side effects.
D010100 Oxygen An element with atomic symbol O, atomic number 8, and atomic weight [15.99903; 15.99977]. It is the most abundant element on earth and essential for respiration. Dioxygen,Oxygen-16,Oxygen 16
D001833 Body Temperature Regulation The processes of heating and cooling that an organism uses to control its temperature. Heat Loss,Thermoregulation,Regulation, Body Temperature,Temperature Regulation, Body,Body Temperature Regulations,Heat Losses,Loss, Heat,Losses, Heat,Regulations, Body Temperature,Temperature Regulations, Body,Thermoregulations
D001835 Body Weight The mass or quantity of heaviness of an individual. It is expressed by units of pounds or kilograms. Body Weights,Weight, Body,Weights, Body
D002045 Bupivacaine A widely used local anesthetic agent. 1-Butyl-N-(2,6-dimethylphenyl)-2-piperidinecarboxamide,Bupivacain Janapharm,Bupivacain-RPR,Bupivacaina Braun,Bupivacaine Anhydrous,Bupivacaine Carbonate,Bupivacaine Hydrochloride,Bupivacaine Monohydrochloride, Monohydrate,Buvacaina,Carbostesin,Dolanaest,Marcain,Marcaine,Sensorcaine,Svedocain Sin Vasoconstr,Bupivacain RPR
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000763 Anesthesia, Caudal Epidural anesthesia administered via the sacral canal. Anesthesia, Sacral Epidural,Caudal Anesthesia,Epidural Anesthesia, Sacral,Sacral Epidural Anesthesia

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