The influence of aging on skin temperature and hemodynamic changes during spinal anesthesia

We investigated the influence of aging on the relationship between arterial pressure and skin temperature as a simple and indirect indicator of cutaneous blood flow. Sole and palm skin temperatures, sublingual temperature, heart rate, mean arterial blood pressure (MAP), and the anesthetic level as determined by cold discrimination, were measured before and during minor surgery under spinal anesthesia in patients under 65 years (young group) and above 65 years (elderly group). The sole skin temperature (Tsole) started to increase in the young group whose anesthesia level reached above L1-L2, and approached the sublingual temperature in those whose anesthesia level reached above T8-T10 after spinal injection. There was, however, no relationship between the anesthesia level and Tsole in the young group. The change in Tsole was less in elderly patients than that in young patients with the same decrease in MAP. These findings suggest that a decrease in peripheral resistance may not be the main cause of hypotension during spinal anesthesia in elderly patients.