Effects of Two Decurarization Methods on  Thermoregulation of Patients Under General  Anesthesia

Pınar Tümtürk; Süleyman Ganidağlı; Berna Kaya Uğur

doi:10.5152/eurjther.2019.19073

Authors

Pınar Tümtürk Department of Anesthesiology and Reanimation, Gaziantep University, Gaziantep https://orcid.org/0000-0003-2876-5876
Süleyman Ganidağlı Department of Anesthesiology and Reanimation, Gaziantep University, Gaziantep https://orcid.org/0000-0002-9644-7688
Berna Kaya Uğur Department of Anesthesiology and Reanimation, Gaziantep University, Gaziantep https://orcid.org/0000-0003-0044-363X

DOI:

https://doi.org/10.5152/eurjther.2019.19073

Keywords:

Decurarization, hypothermia, neostgmine, sugammadex, thermoregulation

Abstract

Objective: Evaluate the effects of two decurarization methods on thermoregulation of patients who received general anesthesia.
Method: Sixty-six male patients that are over 18 years of age with an ASA physical status I-III and scheduled for elective thoracotomy. Patients were warmed with (38°C at medium setting ) air blowing blankets. Decurarization was achieved with 0.02-0.05 mg/kg neostigmine in group N and 3 mg/kg sugammadex in group S after train of four (TOF) value obtained at the end of the operation.
Results: Core temperatures of tympanic membrane and peripheral skin temperatures of sternum and 1/3 upper part of the arm were measured and recorded at 15th, 30th, 45th, 60th, 90th and 120th minutes after extubation. Core temperature of the tympanic membrane and skin temperatures measured at the chest and arm in the first two hours after extubation were similar between the groups.
Conclusion: Decurarization agents had no effect on spontaneous central and skin temperatures in the actively heated postoperative patients that had previously equal intraoperative temperatures. Whereas the temperatures of the peripheral skin surface of the patients who received sugammadex returned to preoperative control levels earlier than that of patients receiving neostigmine.

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References

Fujita Y, Tokunaga C, Yamaguchi S, Nakamura K, Horiguchi Y, Kaneko M. Effect of intraoperative amino acids with or without glucose infusion on body temperature, insulin, and blood glucose levels in patients undergoing laparoscopic colectomy. Acta Anaesthesiol Taiwan 2014; 52: 101-6.

Bock M, Müller J, Bach A, Böhrer H, Martin E, Motsch J. Effects of preinduction and intraoperative warming during major laparotomy. BJA 1998; 80: 159-63.

Suzuki M, Osumi M, Shimada H, Bito H. Perioperative very low-dose ketamine infusion actually increases the incidence of postoperative remifentanil induced shivering double-blind randomized trial. Acta Anaesthesiol Taiwan 2013; 51: 149-54.

Sessler DI. Perianesthetic thermoregulation and heat balance in humans. FASEB J 1993; 7: 638-44.

Sessler DI. Complications and Treatment of Mild Hypothermia. Anesthesiology 2001; 95: 531-43.

De Mattia LA, Barbosa HM, Rocha De MA, Farias LH, Santos AC, Santos MD. Hypothermia in patients during the perioperave period. Rev Es Enform USP 2012; 46: 58-64.

Cobbe KA, Di Staso R, Duff J, Walker K, Draper N. Preventing inadvertent hypothermia: comparing two protocols for preoperative forcedair warming. J Perianesth Nurs 2012; 27(1): 18-24.

Buggy DJ, Crossley AWA. Thermoregulation, mild perioperative hypothermia and post-anaesthetic shivering. Br J Anaesth 2000; 84: 615-28.

Naguib M. Sugammadex: Another milestone in clinical neuromuscular pharmacology. Anesth Analg 2007; 104: 575-81.

Khuenl-Brady KS, Wattwil M, Vanacker BF, Lora-Tamayo JI. Sugammadex provides faster reversal of vecuronium induced neuromucular blockade compared with neostigmine: a multicenter, randomized, controlled trial, Anesth Analg 2010; 10: 64-73.

Cattaneo CG, Frank SM, Hesel TW, El-Rahmany HK, Kim LJ, Tran KM. The accuracy and precision of body temperature monitoring methods during regional and general anesthesia. Anesth Analg 2000; 90: 938-45.

Lenhardt R, Sessler DI. Estimation of Mean Body Temperature from Mean Skin and Core Temperature. Anesthesiology 2006; 105: 1117-21.

Srivastava A, Hunter JM. Reversal of neuromuscular block. BJA 2009; 103: 115-29.

Jung KT, Kim SH, Lee HY, Jung JD, Yu BS, Lim KJ, et al. Effect on thermoregulatory responses in patients undergoing a tympanoplasty in accordance to the anesthetic techniques during PEEP: a comparison between inhalation anesthesia with desflrane and TIVA. Korean J Anesthesiol 2014; 67: 32-7.

Sessler DI. Thermoregulatory defence mechanisms. Crit Care Med 2009; 37: 203-10.

Horosz B, Malec-Milewska M. Inadvertent intraoperative hypothermia. Anaesthesiol Intensive Ther 2013, 45; 38-43.

Mirakhur RH, Dundee JW. A comparison of the effects of atropine and glycopyrrolate on various end organs. J Roy Soc Med 1980; 73: 727-30.

Sımpson KH, Green JH, Ellıs FR. Effect of glycopyrrolate and atropine on thermoregulation after exercise. Br J Clin Pharmac 1986; 22: 579-86

Frank SM, El-Rahmany HK, Cattaneo CG, Barnes RA. Predictors of Hypothermia during Spinal Anesthesia. Anesthesiology 2000; 92: 1330-4.

Washington DE, Sessler DI, McGuire J, Hynson J, Schroeder M, Moayeri A. Painful stimulation minimally increases the thermoregulatory threshold for vasoconstriction during enflurane anesthesia in humans. Anesthesiology 1992; 77: 286-90.