Assessment of palm and axillary temperature changes in determining the success of thoracic paravertebral block in breast cancer patients / 临床麻醉学杂志

Objective To observe the skin temperature changes on blocked area of ultrasoundguided thoracic paravertebral block and to explore the accuracy of the temperature changes in predic ting the effect of nerve block in breast cancer patients.Methods One hundred and twenty breast cancer patients undergoing modified radical mastectomy,aged 29-67 years,ASA physical status Ⅰ-Ⅲ,were selected for the study.Before general anesthesia induction,ultrasound-guided thoracic paravertebral block was performed.After the block site T34 was determined,25 ml 0.25％ ropivacaine was injected around the thoracic paravertebral space.The skins of palm and axillary regions both in blocked and unblocked sites were randomly selected.The skin temperature before nerve block and 15 min after were recorded,and the skin temperature changes were calculated.The sensitivity and specificity of the temperature changes in determining the effect of thoracic paravertebral block was assessed by using the receiver operating characteristic curve (ROC).Pearson correlation was used to analyze the correlation.Results The value of area under curve (AUC) of the ROC of the skin temperature changes in palm regions responding to the effects of block was 0.892 (95％CI 0.803-0.947).The cut-off value was 0.9C which sensitivity and specificity was 87.3％ and 75.9％,respectively.The AUC in axillary regions was 0.813 (95％CI 0.756 0.884),the cut-off value was 0.4 C which sensitivity and specificity was 80.7％ and 71.6％,respectively.The value of AUC in palm regions was larger than in axillary regions (P＜0.05).Conclusion The present study demonstrated that the changes of the skin temperature in palm and axillary regions have a high accuracy in predicting the effect of T3-4 thoracic paravertebral block,which can be used in determining the success of T3-4 thoracic paravertebral block.The assessment of temperature changes in palm regions is more accuracy than in axillary.

Comparative research of difference in measurements of bilateral axillary temperature of the same patient during transfusion / 中国实用护理杂志

Objective To explore the difference in measurements of the same patients' bilateral ax-illary temperature during transfusion. Methods Bilateral axillary temperature 80 patients with normal temperature who underwent transfusion in hospital was measured before infusion, 30 to 35 minutes after in-fusion, and the experimental data went through statistical analysis. Results No significant difference ex-isted between both sides of the axillary temperature before transfusion, significant difference existed be-tween axillary temperature of the transfusion-side before transfusion and after transfusion, no significant dif-ference between axillary temperature of the no transfusion-side before transfusion and after transfusion, the mean values of both sides of the axillary temperature were significant after the transfusion compared with the normal values of human body in textbook,the axillary temperature of no-transfusion side was closer to the normal human axillary temperature in the textbook. Conclusions Transfusion affect axil-lary temperature,mainly on the transfusion side,so it is appropriate to take temperature in armpit side without transfusion.

Argumentation study in clinical axillary temperature measurement / 中国实用护理杂志

Objective To survey the difference of measurement results between axillary temperature measurement used in clinic and standardized axillary temperature measurement in textbooks. Methods For the same patients and in the nearest time interval, the two methods mentioned above were used to mea-sure the axillary temperature. Totally 782 patients were measured. Results There was no statistical sig-nificance between the measuring results of the two methods. Conclusions Axillary temperature measure-ment used in clinic should be standardized so that more scientific data will be got,effective operation and humanized service can be realized.

Pulseless Electrical Activity (PEA) and Severe Arrhythmia Provoked by Inadvertent Profound Hypothermia : A case report / 대한마취과학회지

A 70-year-old man was scheduled to undergo corrective osteotomy under general anesthesia. During the operation, a fluid warmer was applied, with his body temperature assessed with the use of an axillary temperature probe. Near the end of the operation the pressure waveform from the radial artery and pulse oxymeter became flat. Palpation of the carotid artery revealed no heart rate, the electrocardiographic tracing continued to be sinus rhythm, and pulseless electrical activity was diagnosed. The infusion of cardiovascular drugs was also performed. However, the hemodynamic status of the patient deteriorated to severe hypotension, with atrial fibrillation, paroxysmal ventricular tachycardia. The patient was assessed as hypothermia from a rectal temperature of 30.5oC. After active warming methods for 1 hour the cardiovascular status of the patient became stabilized.

Temperature Difference Between the Brain and Axilla in Patients Under Hypothermia

OBJECTIVE: The brain temperature is about 0.4-1 degrees C higher than that of the other peripheral body area. But most of these results have been obtained in normothermic condition. The objective of this study is to evaluate the temperature difference between the brain and axilla, in patients under hypothermia. METHODS: Sixty-three patients(37 women and 26 men) who underwent craniotomy with implantation of the thermal diffusion flowmetry sensor were included in this study. The temperature of the cerebral cortex and axilla was measured every 2 hours, simultaneously. The patient group was divided according to axillary temperature hyperthermia(over 38 degrees C), normothermia(36-38 degrees C) and hypothermia(under 36 degrees C). Total 1671 paired sample data were collected and analyzed. RESULTS: The temperature difference between the cerebral cortex and the axilla was 0.45+/-1.04 degrees C in hyperthermic patients, 0.97+/-1.1 degrees C in normothermic patients and 1.04+/-0.81 degrees C in hypothermic patients. The temperature difference has statistical significance in each group(unpaired t-test, p<0.05). CONCLUSION: From our study the temperature difference between the brain and the axilla in hypothermic condition increased more than that of normothermic state. And in hyperthermic condition, the temperature difference decreased.

Comparison of Rectal Temperature with Axillary and Tympanic Temperature / 기본간호학회지

Body temperature should be measured accurately to assess neonate's condition for proper care. Temperatures measured in rectal, axillary and tympanic site were compared in 129 normal neonates to find out proper nursing time for measuring temperature and the validity of fever detection. The results were as follows : 1. Mean temperatures of axillary and tympanic site(36.85degrees C, 37.12degrees C) were significantly lower than those of rectal site(37.19degrees C). 2. Mean nursing time for measuring body temperature was significantly higher and lower in axillary and tympanic temperatures(159.49 seconds, 11.07 seconds) than in rectal temperature(105.62 seconds). 3. Tympanic and axillary temperatures were significantly correlated with rectal temperature(r=0.85, r=0.78) and the significant correlation was demonstrated between tympanic and axillary temperatures(r=0.76). 4. Sensitivity, specificity, positive and negative predictive values were 0.87, 0.90, 0.72, 0.96 for detecting fever respectively. The above findings indicated that the tympanic thermometer offers a useful alternative to conventional methods.