Negishi C, Ozaki M, Suzuki H, Ohno T
Department of Anesthesia, Saiseikai Kawaguchi General Hospital, Japan.
Masui. 1996 May;45(5):558-64.
Eleven healthy pregnant women were studied to determine temperature changes after induction of epidural anesthesia during cesarean delivery. Epidural anesthesia was induced by 2% lidocaine 15-20 ml (T 5 level) at 25 degrees C ambient temperature. Tympanic membrane and skin surface temperature, skin-temperature gradients (forearm-fingerchip, calf-toe), thermal perception (1-10 scale VAS) and the presence or absence of shivering were measured. Sixty minutes after induction, tympanic temperature decreased for 0.52 +/- 0.26 degrees C and average skin temperature increased for 0.56 +/- 0.17 degrees C. Central hypothermia and shivering did not produce a cold sensation. Temperature gradients of upper limb increased to 2.0 +/- 3.7 degrees C (50 minutes after induction) and the lower limbs decreased to -1.4 +/- 0.55 degrees C (30 minutes after induction). Shivering occurred in 3 patients. We conclude that epidural anesthesia impaired thermoregulatory control and induced redistribution hypothermia as in nonpregnant individuals.
对11名健康孕妇进行了研究，以确定剖宫产术中硬膜外麻醉诱导后的体温变化。在环境温度为25摄氏度时，用2%利多卡因15 - 20毫升（T5水平）诱导硬膜外麻醉。测量鼓膜和皮肤表面温度、皮肤温度梯度（前臂-指尖、小腿-脚趾）、热感觉（1 - 10级视觉模拟评分法）以及是否存在寒战。诱导后60分钟，鼓膜温度下降0.52±0.26摄氏度，平均皮肤温度上升0.56±0.17摄氏度。中枢性体温过低和寒战并未产生寒冷感觉。上肢温度梯度在诱导后50分钟增加到2.0±3.7摄氏度，下肢温度梯度在诱导后30分钟下降到-1.4±0.55摄氏度。3名患者出现了寒战。我们得出结论，硬膜外麻醉会损害体温调节控制，并像在非孕妇个体中一样诱发再分布性体温过低。
