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Relative Contribution of Skin and Core Temperatures to Vasoconstriction and Shivering Thresholds during Isoflurane Anesthesia

 

作者: Rainer Lenhardt,   Robert Greif,   Daniel Sessler,   Sonja Laciny,   Angela Rajek,   Hiva Bastanmehr,  

 

期刊: Anesthesiology  (OVID Available online 1999)
卷期: Volume 91, issue 2  

页码: 422-429

 

ISSN:0003-3022

 

年代: 1999

 

出版商: OVID

 

关键词: Temperature;thermoregulation

 

数据来源: OVID

 

摘要:

BackgroundThermoregulatory control is based on both skin and core temperatures. Skin temperature contributes [approximate] 20% to control of vasoconstriction and shivering in unanesthetized humans. However, this value has been used to arithmetically compensate for the cutaneous contribution to thermoregulatory control during anesthesia‐although there was little basis for assuming that the relation was unchanged by anesthesia. It even remains unknown whether the relation between skin and core temperatures remains linear during anesthesia. We therefore tested the hypothesis that mean skin temperature contributes [approximate] 20% to control of vasoconstriction and shivering, and that the contribution is linear during general anesthesia.MethodsEight healthy male volunteers each participated on 3 separate days. On each day, they were anesthetized with 0.6 minimum alveolar concentrations of isoflurane. They then were assigned in random order to a mean skin temperature of 29, 31.5, or 34 [degree sign]C. Their cores were subsequently cooled by central‐venous administration of fluid at [almost equal to] 3 [degree sign]C until vasoconstriction and shivering were detected. The relation between skin and core temperatures at the threshold for each response in each volunteer was determined by linear regression. The proportionality constant was then determined from the slope of this regression. These values were compared with those reported previously in similar but unanesthetized subjects.ResultsThere was a linear relation between mean skin and core temperatures at the vasoconstriction and shivering thresholds in each volunteer: r2= 0.98 +/‐ 0.02 for vasoconstriction, and 0.96 +/‐ 0.04 for shivering. The cutaneous contribution to thermoregulatory control, however, differed among the volunteers and was not necessarily the same for vasoconstriction and shivering in individual subjects. Overall, skin temperature contributed 21 +/‐ 8% to vasoconstriction, and 18 +/‐ 10% to shivering. These values did not differ significantly from those identified previously in unanesthetized volunteers: 20 +/‐ 6% and 19 +/‐ 8%, respectively.ConclusionsThe results in anesthetized volunteers were virtually identical to those reported previously in unanesthetized subjects. In both cases, the cutaneous contribution to control of vasoconstriction and shivering was linear and near 20%. These data indicate that a proportionality constant of [approximate] 20% can be used to compensate for experimentally induced skin‐temperature manipulations in anesthetized as well as unanesthetized subjects.

 

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