RESUMO
Temperature monitoring is a standard of anesthesia care as listed in Standard V of the American Association of Nurse Anesthetists Standards of Nurse Anesthesia Practice. The purpose of this quantitative correlational study was to examine which temperature modality (tympanic vs temporal) best correlates with pediatric surgical patients' core rectal temperature. Data were from a sample of 106 intraoperative pediatric surgical patients with ASA physical classification 1 or 2 who were scheduled for elective surgical procedures. Findings from this study support that tympanic temperature correlates more to core rectal temperature both before (Pearson r = 0.36 vs 0.16) and after surgery (Pearson r = 0.57 vs 0.33) and had less bias with core rectal temperature (r = -0.37 vs -0.55) than temporal temperature. Multiple regression analyses further supported tympanic temperature as the best predictor of core rectal temperature both before surgery (R² = 0.17, R²adj = 0.13, F(5, 100) = 4.18, P = .0007) and after surgery (R² = 0.34, R²adj = 0 .30, F(7, 99) = 7.47, P = .001). Although generalizations are limited beyond this study population, the findings add support to recommend tympanic temperature as the temperature modality of choice in the pediatric surgical population.
RESUMO
Interscalene brachial plexus blockade is regularly used for postoperative pain management following shoulder surgery. A known but generally benign side effect of this technique is Horner syndrome. Another syndrome known as harlequin syndrome exists but does not appear to be as common. This syndrome consists of contralateral facial flushing and sweating secondary to ipsilateral sympathetic chain inhibition. Despite the alarming presentation in the perioperative setting, this syndrome appears to be benign and self-limiting when precipitated by regional anesthetic technique. This article describes an occurrence of harlequin syndrome without observed ptosis or miosis following a postoperative interscalene nerve block.