Comparison of the effects of sevoflurane and propofol on core body temperature during laparoscopic abdominal surgery

Kwak, Hyun Jeong; Min, Sang-Kee; Yi, In-Kyong; Chang, Young Jin; Kim, Jong-Yeop

doi:10.4097/kjae.2011.61.2.133

Cited by 8 publications

(4 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although only correlative, prior studies have demonstrated propofol to significantly reduce core body temperatures within 10 minutes of administration, by redistributing core heat to the periphery. [ 32 , 33 ] Hence, when choosing an anesthetic for maintenance of sedation, our case supports utility of propofol for immediately controlling hyperpyrexia in MDMA toxicity.…”

Section: Discussionsupporting

confidence: 59%

Protracted hyperthermia and delayed rhabdomyolysis in ecstasy toxicity

et al. 2020

View full text Add to dashboard Cite

Rationale: Despite toxicity and unpredictable adverse effects, ecstasy use has increased in the United States. Onset of hyperpyrexia, rhabdomyolysis, disseminated intravascular coagulation (DIC), among other symptoms, occurs within hours of ingestion. Moreover, patients who experience hyperpyrexia, altered mental status, DIC, and multiorgan failure, rarely survive. This case presents a chronic ecstasy user whose symptoms would have predicted mortality. The report demonstrates a patient who experiences protracted hyperthermia, with delayed rhabdomyolysis and DIC. In addition, his peak creatine kinase (CK) of 409,440 U/L was far greater than the expected 30,000 to 100,000 U/L, being the second largest CK recorded in a survivor. Patient concerns: This case report presents a 20-year-old man who presented to the emergency department after experiencing a severe reaction to ecstasy. He was a chronic user who took his baseline dosage while performing at a music event. He experienced hyperpyrexia immediately (106.5°F) while becoming stiff and unresponsive. Before emergency medical service arrival, his friends placed cold compresses on the patient and rested him in an ice filled bathtub. Diagnoses: Per history from patient's friends and toxicology results, the patient was diagnosed with ecstasy overdose, which evolved to include protracted hyperthermia and delayed rhabdomyolysis. Interventions: Due to a Glasgow coma scale score of 5, he was intubated and sedated with a propofol maintenance. Hyperpyrexia resolved (temperature dropped to 99.1°F) after start of propofol maintenance. He was extubated after 24 hours, upon which he experienced hyperthermia (101.4°F at 48 hours), delayed rhabdomyolysis, and DIC (onset at 37 hours). He remained in hyperthermia for 120 hours until carvedilol permanently returned his temperature to baseline. His plasma CK reached a peak of 409,440 U/L at 35 hours. Outcomes: After primary management with intravenous fluids, the patient returned to baseline health without any consequences and was discharged after 8 days. A follow-up of 3 months postdischarge revealed no complications or disability. Lessons: Clinically, the case highlights how physicians should be aware of the unusual time course adverse effects of ecstasy can have. Lastly, as intensity and duration of hyperpyrexia are predictors of mortality, our case indicates maintenance of sedation with propofol and use of oral carvedilol; both are efficacious for temperature reduction in ecstasy toxicity.

show abstract

Section: Discussionsupporting

confidence: 59%

Protracted hyperthermia and delayed rhabdomyolysis in ecstasy toxicity

et al. 2020

View full text Add to dashboard Cite

show abstract

“…The type of anesthesia (balanced anesthesia versus total intravenous aneasthesia (TIVA)) was not determined by the setting, but was entirely subject to the anesthetist's discretion. The investigations performed by Kwak et al support this decision in that body temperature did not differ when using the two types of anesthesia mentioned above [12]. Although Propofol has been reported to cause a lower body temperature in comparison to narcotic gases they were comparable in conditions of mild perioperative hypothermia [13].…”

Section: Methodsmentioning

confidence: 92%

Intraoperative Rise of Surface Temperature Monitors Success of Sympathectomy in Palmoaxillary Hyperhidrosis

Krämer¹,

Skuballa²,

Eichfeld³

2013

OJTS

View full text Add to dashboard Cite

Objectives: Patients with hyperhidrosis suffer from an extreme perspiration that cannot be aligned with natural or situational standards. Endoscopic sympathectomy is a meaningful option for palmar and axillary hyperhidrosis. A standardized method of monitoring the immediate intraoperative success has not been established yet. The presented investigation shows one proposed sollution by monitoring skin surface temperature. The main aspect is to demonstrate a significant rise in temperature with utility for monitoring the immediate success of surgery. Methods: Twenty patients with primary hyperhidrosis were observed and treated in a standardized setting against a control group (n = 10). We obtained diverse data that permit determination of a point of time of measurement of surface temperature and definition of a degree of temperature variance. Results: After 5 minutes a significant change of 0.5˚ Celcius was noted on the palms; after 10 minutes on average 1.2˚ Celcius. Axillary temperature had significantly changed after 10 minutes with a mean temperature variation of 0.8˚ Celcius on the right side and 0.6˚ Celcius on the left side. Conclusions: Under consideration of appropriate time intervals of measurement and determined changes in surface temperature an early control of correct clip application in ETS is possible. In the palmar aspect an increase of 0.5˚ Celcius at an 5 minutes interval, and more than 1˚ Celcius at 10 minutes after placement of the clip as compared to basic values before application of the clip can be proposed.

show abstract

“…Remifentanil inhibits the sympathetic nervous system and leads to vasodilation, which may affect thermoregulation, depending on the dose. The possibility that the effect of propofol or remimazolam was partially masked by remifentanil, thus reducing the measured differences, cannot be excluded [ 12 ]. Second, anesthetic-induced thermoregulatory inhibition is dose-dependent.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Core Body Temperatures in Patients Administered Remimazolam or Propofol during Robotic-Assisted and Laparoscopic Radical Prostatectomy

Lee

et al. 2022

Medicina

View full text Add to dashboard Cite

Background and Objectives: Different types of anesthetics affect thermoregulatory mechanisms, such as the redistribution of body temperature, loss of skin heat, or inhibition of thermoregulatory vasoconstriction. Therefore, we compared remimazolam with propofol in terms of core body temperature in patients undergoing robotic-assisted and laparoscopic radical prostatectomy. Materials and methods: Ninety patients were randomly assigned to either the propofol–remifentanil (PR) group or the remimazolam–remifentanil (RR) group. The PR group (n = 45) received effect-site concentrations of 6.0 μg/mL of propofol and 4 ng/mL of remifentanil, followed by 0.9 mg/kg of 1% rocuronium and maintenance with effect-site concentrations of 2–4 μg/mL of propofol and 3 ng/mL of remifentanil. The RR group (n = 45) received remimazolam 6 mg/kg/h by continuous intravenous infusion and the effect-site concentration of 4 ng/mL of remifentanil, followed by 0.9 mg/kg of 1% rocuronium, remimazolam 1–3 mg/kg/h, and remifentanil 3 ng/mL. The primary outcome was core body temperature, and secondary outcomes included vasoconstriction threshold (°C) and time to onset of vasoconstriction (min). Results: The core body temperature in the RR group was significantly higher at 60, 80, 100, 120, 140, 160, and 180 min after induction than in the PR group (p < 0.01). The vasoconstriction threshold was significantly higher in the RR group (35.2 ± 0.4) than in the PR group (34.8 ± 0.3) (p < 0.01). The time to onset of vasoconstriction was significantly less in the RR group (150.5 ± 10.2) than in the PR group (158.5 ± 8.4) (p < 0.01). However, the incidence of intraoperative hypothermia was not significant between two groups. Conclusions: Remimazolam appears to reduce vasoconstriction threshold less than and had a faster onset of vasoconstriction, resulting in superior thermoregulatory control.

show abstract

Comparison of the effects of sevoflurane and propofol on core body temperature during laparoscopic abdominal surgery

Cited by 8 publications

References 25 publications

Protracted hyperthermia and delayed rhabdomyolysis in ecstasy toxicity

Protracted hyperthermia and delayed rhabdomyolysis in ecstasy toxicity

Intraoperative Rise of Surface Temperature Monitors Success of Sympathectomy in Palmoaxillary Hyperhidrosis

Comparison of Core Body Temperatures in Patients Administered Remimazolam or Propofol during Robotic-Assisted and Laparoscopic Radical Prostatectomy

Contact Info

Product

Resources

About