Body temperature change during anesthesia for electroconvulsive therapy: implications for quality incentives in...

The American Society of Anesthesiologists has announced that perioperative normothermia is a "Quality Incentive in Anesthesiology." We examined whether we could meet this quality incentive in a simple population: patients undergoing anesthesia for electroconvulsive therapy (ECT).

We compared infrared-measured ear temperature before anesthesia to temperature upon delivery of patients to the postanesthesia care unit (PACU) after 101 consecutive brief anesthetics to facilitate ECT.

For 35 procedures, the patients had an infrared ear thermometer temperature of <36 degrees C before anesthesia was administered, and 18 had a temperature of <36 degrees C after anesthesia when transferred to the PACU. For 30 anesthetics, the patients' temperature decreased during anesthesia, for 64 anesthetics it increased during anesthesia, and for 7 it did not change. Overall examination of the data demonstrated no correlation between preprocedure and postprocedure temperature.

We conclude that there was no consistent change in temperature during anesthesia between our study patients when anesthesia was administered to facilitate ECT. If patients' tympanic temperatures were below 36 degrees C upon admission to the PACU, it would be incorrect to conclude that intraprocedural temperature management measures were substandard. Also, current methods of measuring temperature may be inadequate to ascertain if patients are hypothermic after surgery. As the avoidance of hypothermia is a meritorious goal, anesthesia departments need to ensure that their temperature monitoring equipment is adequate to ensure accurate measurement of postanesthetic temperature if this variable is to be used as a quality incentive.