Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2021.02.062
Brazilian Journal of Anesthesiology
Original Investigation

Evaluation of dexmedetomidine anesthesia-related temperature changes: preliminary retrospective observational study

Avaliação de alterações de temperatura relacionadas à anestesia com dexmedetomidina: estudo observacional retrospectivo preliminar

Felipe Aparecido Ferreira da Cruz; Luiz Fernando dos Reis Falcão; José Luiz Gomes do Amaral; Helga Cristina Almeida da Silva

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Abstract

Introduction and objective
Dexmedetomidine is a potent adrenergic alpha-2 agonist, and analgesic, sedative, anxiolytic and sympatholytic. Given there have been reports of dexmedetomidine associated temperature changes, in which these events have been associated with complications, our objective was to describe both temperature increase and decrease, during the intra and postoperative period (initial 24 hours), and factors associated, in patients who received dexmedetomidine for anesthesia/sedation in the surgical suite.

Method
Retrospective observational study, analyzing charts of patients ≥ 18 years submitted to anesthesia/sedation with dexmedetomidine, between 1/1/2017 and 31/12/2017. Upper temperature threshold was considered ≥ 37.8 °C, and lower, < 35 °C. The association with dexmedetomidine was assessed by the OMS/UMC causality system and by the Naranjo algorithm.

Results
The sample included 42 patients who received dexmedetomidine and whose temperature data were available, with predominance of men 26 (62%), 49.4/16.5 years old (mean/standard deviation), and weight 65/35.8 kg. None of the patients presented intraoperative temperature equal to or above 37.8 °C or below 35 °C. During the postoperative period, one patient presented an increase ≥ 37.8 °C (2.4%) and three, temperature decrease < 35 °C (7%). Surgery/anesthesia time and exposure time to dexmedetomidine were not appropriate linear predictors of maximum temperature. Older age (p < 0.01), longer exposure to dexmedetomidine (p < 0.05) and shorter surgery time (p < 0.01) were significant linear predictors for lower minimum temperature.

Conclusions
Increase ≥ 37.8 °C/decrease < 35 °C of temperature possibly associated with dexmedetomidine did not occur in the intraoperative period and had a low frequency during the postoperative period.

Abbreviations
MHmalignant hyperthermiaUMCUppsala Monitoring CentreICUIntensive Care UnitWHOWorld Health Organization

Keywords

Dexmedetomidine;  Anesthesia;  Body temperature

Resumo

Justificativa e objetivo: Dexmedetomidina é potente agonista alfa-2 adrenérgico com ação analgésica, sedativa, ansiolítica e simpatolítica. Como há relatos de alteração da temperatura associada à dexmedetomidina, eventos esses associados a complicações, nosso objetivo foi descrever variação de temperatura, tanto aumento como diminuição, intra e pós-operatória (primeiras 24 horas), e fatores associados em pacientes que receberam dexmedetomidina para anestesia/sedação em centro cirúrgico. Método: Estudo observacional retrospectivo, com análise de prontuários de pacientes ≥ 18 anos submetidos a anestesia/sedação com dexmedetomidina, entre 1/1/2017 e 31/12/2017. Considerou-se como limite o aumento de temperatura ≥ 37,8ºC e diminuição da temperatura < 35ºC. A associação à dexmedetomidina foi avaliada pelo teste de causalidade OMS/UMC e pela escala Naranjo. Resultados: A amostra incluiu 42 pacientes que usaram dexmedetomidina cujos dados de temperatura estavam disponíveis, com predomínio de homens (26(62%)) de 49,4/16,5 anos (média/desvio padrão) e peso de 65/35,8 kg. Nenhum paciente apresentou temperatura intraoperatória maior ou igual a 37,8ºC ou menor que 35ºC. No pós-operatório, um paciente apresentou aumento ≥ 37,8ºC (2,4%) e três, diminuição da temperatura < 35ºC (7%). Tempo de cirurgia/anestesia e tempo de exposição à dexmedetomidina não foram bons preditores lineares da temperatura máxima. Idade mais avançada (p < 0,01), maior tempo de exposição à dexmedetomidina (p < 0,05) e menor tempo de cirurgia (p < 0,01) foram previsores lineares significantes para temperatura mínima mais baixa. Conclusões: Aumento ≥ 37,8ºC /diminuição < 35ºC da temperatura possivelmente associadas à dexmedetomidina não ocorreram no intraoperatório e tiveram baixa frequência no pós- -operatório.

Palavras-chave

Dexmedetomidina; Anestesia; Temperatura corporal

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