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Esophageal, tympanic, rectal, and skin temperatures in children undergoing surgery with general anesthesia
Olayinka R Eyelade1, Adebola E Orimadegun, Oluranti A Akinyemi
1Department of Anaesthesia, College of Medicine, University of Ibadan, Ibadan, Nigeria.
Insights
Esophageal temperature measurement closely aligns with rectal temperature in children during general anesthesia. Skin temperature is the least reliable for monitoring core body temperature in this surgical population.
Area of Science:
- Pediatric Anesthesiology
- Medical Device Technology
- Clinical Thermometry
Background:
- Accurate core body temperature monitoring is crucial during pediatric surgery.
- Various sites for temperature measurement exist, each with potential limitations.
- General anesthesia can influence thermoregulation in children.
Purpose of the Study:
- To assess agreement between esophageal, skin, ear canal, and rectal temperature measurements in children undergoing surgery.
- To analyze trends in body temperature differences across these sites during general anesthesia.
- To identify the most reliable site for core temperature monitoring in this population.
Main Methods:
- Prospective study involving 36 children undergoing surgery under general anesthesia.
- Temperature measurements taken at esophagus, skin, ear canal, and rectum at multiple time points.
- Statistical analysis using Spearman correlation and Bland-Altman methods.
Main Results:
- Highest correlation found between esophageal and rectal temperatures (r = 0.96).
- Lowest mean temperature difference observed between esophageal and rectal sites (-0.03°C).
- Skin temperature showed the largest mean difference compared to esophageal (3.24°C), indicating unreliability.
Conclusions:
- Esophageal temperature is a reliable indicator of core body temperature in pediatric surgical patients.
- Rectal and tympanic temperatures are acceptable alternatives when esophageal monitoring is not feasible.
- Skin temperature measurement is not recommended for accurate core temperature assessment in this setting.
Abstract:
The purpose of this study was to determine the degrees of agreement between various sites of temperature measurement and examine the trend of body temperature in children during surgery under general anaesthesia. Thirty-six consecutive children who underwent surgery with general anaesthesia, had temperatures measured at the oesophagus, skin, ear canal and rectum at baseline, every 15 minutes for the first hour and every 30 minutes thereafter. Spearman correlation and Bland-Altman analyses were used to compare data and trends of mean differences assessed by line graphs. The median age of the sample was 48 months. There were 575 temperature measurements taken. The inter-method correlation coefficients was highest for the oesophageal vs rectal (r = 0.96) temperature and lowest for rectal vs skin (r = -0.11) temperature. The lowest mean difference (95% CI) in temperature at commencement of surgery was between the oesophageal and rectal sites, -0.03°C (-0.08, -0.01) while the highest mean difference (95% CI) temperature was between oesophageal and skin sites, 3.24°C (2.65, 3.85). The trend in differential temperatures between sites remained throughout the duration of surgery. Bland-Altman plots showed that the least difference (bias) at baseline (0.3°C) was between the oesophageal and tympanic temperatures while at 1 hour (0.13°C ) was between the oesophageal and rectal temperatures. The oesophageal site was the closest to rectal for monitoring core temperature while the skin was the least reliable site in the study population. In the situation where oesophageal probe is not routine or functioning, rectal or tympanic temperatures may be used.
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