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A Spurious Increase of Core Temperature During Laparoscopy

Section Editor(s): Saidman, LawrenceEgan, Brian J. MD, MPH; Clark, Carlee MD

doi: 10.1213/ane.0b013e31818fa297
Letters to the Editor: Letters & Announcements
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Department of Anesthesiology; Columbia University; New York, New York; BE2122@columbia.edu

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To the Editor:

We report a spurious increase of core body temperature during a laparoscopic revision of a gastric bypass and hiatal hernia repair. The patient was a 53-year-old female with a history of a previous laparoscopic Roux-en-Y gastric bypass. Her medical history included hypertension and recurrent morbid obesity. She denied drug allergies or previous difficulties with anesthesia. Induction was with lidocaine, midazolam, and fentanyl, followed by propofol and succinylcholine, and maintenance consisted of air/O2, sevoflurane (ET 1.8%–2.5%) and vecuronium. After induction, an orogastric tube, esophageal temperature probe and upper body Bair Hugger (42°C) were placed. Coincident with surgical dissection along the esophagus, a rapid increase in monitored esophageal temperature from 36.7°C to a peak of 38.2°C occurred. Correct location of the esophageal position of the temperature probe was confirmed and temperature within the Bair Hugger blanket was decreased to 37°C and then 33°C. Reassuringly, heart rate, blood pressure, and end-tidal CO2 levels remained at baseline. As dissection on the esophagus ceased, temperature returned rapidly to baseline leading us to conclude these changes were spurious and due to the use of cautery adjacent to the temperature sensor. Medline search revealed a similar report during a laparoscopic Nissen fundoplication in a pediatric patient.1

Brian J. Egan, MD, MPH

Carlee Clark, MD

Department of Anesthesiology

Columbia University

New York, New York

BE2122@columbia.edu

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REFERENCE

1. Sanders JC. Deep positioning of an esophageal temperature probe may lead to overestimation of core body temperature during laparoscopic Nissen fundoplication in infants. Paediatr Anaesth 2005;15: 351–2
© 2009 International Anesthesia Research Society