[Excessive sweating and hypothermia after spinal morphine: case report.]

Anesthesia and surgery often promote significant temperature changes. Hypothermia during anesthesia is the most common perioperative thermal disorder. This report describes an unusual body heat balance change associated to spinal morphine.

Female patient, 44 years old, physical status ASA I, with no previous diseases, admitted for abdominal hysterectomy due to uterine myomatosis. Spinal anesthesia was performed with 20 mg hyperbaric bupivacaine and 100 mug morphine and surgical procedure was eventless. In the post-anesthetic recovery unit (PACU), 3h30 minutes after blockade, patient presented excessive sweating, even leading to detachment of electrodes and adhesive tapes, mild sleepiness and decreased tympanic temperature to 35.2 masculineC. Temperature was maintained below 36 masculineC for the next 60 minutes and 90 minutes later temperature was 36.2 masculineC with total remission of symptoms.

In addition to classic excessive heat loss mechanisms during neuraxial block, there may be direct disorders in the hypothalamic temperature control centers, in this case associated to spinal morphine.