Temperature monitoring and management during neuraxial anesthesia: An observational study

Temperature monitoring and thermal management are rare during spinal or epi dural anesthesia because clinicians apparently restrict monitoring to patie nts with an expected risk of hypothermia. This implies that anesthesiologis ts can predict patient thermal status without monitoring core temperature. We therefore, tested the hypotheses that during neuraxial anesthesia: 1) am ount of core hypothermia depends on the magnitude and duration of surgery; 2) temperature monitoring and thermal management are used selectively inpat ients at high risk of hypothermia; and 3) anesthesiologists can estimate pa tient thermal status. We evaluated thermal status on arrival in the recover y room along with intraoperative thermal management and monitoring in 120 p atients. Anesthesiologists were asked if their patients were hypothermic (< 36 degrees C). There was no correlation between the magnitude or duration o f surgery and initial postoperative core temperature in unwarmed patients. Temperature monitoring and thermal management were not used selectively in high-risk patients. Initial postoperative tympanic membrane temperatures we re <36 degrees C in 77% of patients and <35 degrees C in 22%. Body temperat ure was monitored intraoperatively in 27% of the patients and forced-air wa rming was used in 31%. Anesthesiologists failed to accurately estimate whet her their patients were hypothermic. Our results suggest that temperature m onitoring and management during neuraxial anesthesia is currently inadequat e.