Observational study of peripheral skin temperature changes following spinal anaesthesia for caesarean birth

IF 2.6 3区 医学 Q2 ANESTHESIOLOGY International journal of obstetric anesthesia Pub Date : 2024-05-01 DOI:10.1016/j.ijoa.2023.103970
L. Kessack, G. Davenport, C. McGlennan, J.H. Bamber
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Abstract

Background

Spinal anaesthesia is widely used in obstetric anaesthesia practice but there is limited knowledge about the development of sympathetic blockade following spinal anaesthesia for caesarean birth. This study investigated the characteristics of sympathetic blockade by measuring peripheral skin temperature changes in the feet of patients given spinal anaesthesia for elective caesarean birth.

Methods

A prospective observational study was conducted involving 60 eligible parturients scheduled for elective caesarean birth with spinal anaesthesia. Skin temperature probes were attached to the dorsum of both feet, and temperature measurements were recorded every minute. The dose of spinal anaesthesia given, and other relevant patient data, were collected.

Results

All participants had successful spinal anaesthesia. Following spinal anaesthesia, a sustained rise in skin temperature of both feet was observed, indicating the presence of sympathetic blockade. The maximum rate of temperature increase occurred between 6 and 15 min after the intrathecal injection and plateaued from 22 min after the injection. Control participants did not show any changes in foot temperature.

Conclusions

This study demonstrates that successful spinal anaesthesia for caesarean birth results in a consistent and reliable rise in skin temperature of the feet that is evident after six minutes from intrathecal injection. The observed temperature changes provide indirect objective evidence of bilateral sympathetic blockade. Measurement of feet skin temperatures may serve as an additional objective indicator of successful spinal anaesthesia, along with tests of lower limb motor block and sensory block height. These findings contribute to the understanding of sympathetic blockade during spinal anaesthesia.

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剖腹产脊髓麻醉后外周皮肤温度变化的观察研究
背景脊髓麻醉被广泛应用于产科麻醉实践中,但人们对剖腹产脊髓麻醉后交感神经阻滞的发展了解有限。本研究通过测量接受脊髓麻醉的择期剖腹产患者足部外周皮肤温度的变化,来研究交感神经阻滞的特征。将皮肤温度探针固定在双脚脚背上,每分钟记录一次温度测量结果。结果 所有参与者都成功进行了脊髓麻醉。脊髓麻醉后,观察到双脚皮肤温度持续上升,表明存在交感神经阻滞。体温上升的最大速度出现在鞘内注射后的 6 至 15 分钟,从注射后的 22 分钟开始趋于平稳。结论 本研究表明,剖腹产脊髓麻醉成功后,足部皮肤温度会持续、可靠地升高,这在鞘内注射 6 分钟后就很明显。观察到的温度变化为双侧交感神经阻滞提供了间接的客观证据。测量足部皮肤温度可与下肢运动阻滞和感觉阻滞高度测试一起作为脊髓麻醉成功的额外客观指标。这些发现有助于了解脊髓麻醉期间交感神经阻滞的情况。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.70
自引率
7.10%
发文量
285
审稿时长
58 days
期刊介绍: The International Journal of Obstetric Anesthesia is the only journal publishing original articles devoted exclusively to obstetric anesthesia and bringing together all three of its principal components; anesthesia care for operative delivery and the perioperative period, pain relief in labour and care of the critically ill obstetric patient. • Original research (both clinical and laboratory), short reports and case reports will be considered. • The journal also publishes invited review articles and debates on topical and controversial subjects in the area of obstetric anesthesia. • Articles on related topics such as perinatal physiology and pharmacology and all subjects of importance to obstetric anaesthetists/anesthesiologists are also welcome. The journal is peer-reviewed by international experts. Scholarship is stressed to include the focus on discovery, application of knowledge across fields, and informing the medical community. Through the peer-review process, we hope to attest to the quality of scholarships and guide the Journal to extend and transform knowledge in this important and expanding area.
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