Determination of the time to repeat doses in epidural anesthesia by the change in skin temperature

Sato, S.; Yamaguchi, H.; Okubo, N.; Mizuyama, K.; Fukuda, T.; Naito, H.

Masui. Japanese Journal of Anesthesiology 36(12): 1985-1990

1987


ISSN/ISBN: 0021-4892
PMID: 3446853
Document Number: 288180
Using the changes in skin temperature, we studied if we can estimate the time to repeat dose for epidural anesthesia. In this study of 100 upper abdominal operations, the skin temperature was monitored at two sites, the digital pad of the thumb and the large tow. When the degree of the decrease in skin temperature, which had increased and reached a stable point after the epidural anesthesia, became as much as 0.3 .apprx. 0.5.degree. C, we added the half of the initial dose. Although the changes in skin temperature of the hand were not useful, those of the toe was useful to estimate the time for an additional dose in 40 cases. In this group, we could estimate the time interval to repeat doses by the changes in skin temperature of the toe. In twenty-nine patients this monitoring was not. So the effectiveness of this monitoring was confirmed in 58% of the patients. In the rest of 31 patients, the operation came to an end before the change in skin temperature. The first interval of repeating was 96.9 .+-. 18.0 min (N = 40) and that of second, third, and fourth were 74.8 .+-. 19.1 min (N = 28), 76.2 .+-. 21.1 min (N = 13), 67.6 .+-. 13.3 min (N = 7) respectively, and the interval after the second were significantly shorter than that of the initial interval (P < 0.01). The monitor of skin temperature at the digital pad is useful for estimating the time to repeat doses of epidural anesthesia in upper abdominal surgeries.

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