title: Effect on thermoregulatory responses in patients undergoing a tympanoplasty in accordance to the anesthetic techniques during PEEP: a comparison between inhalation anesthesia with desflurane and TIVA.
abstract: BACKGROUND
  It has been known that positive end-expiratory pressure (PEEP) increases the vasoconstriction threshold by baroreceptor unloading. We compared the effect on the thermoregulatory responses according to anesthetic techniques between an inhalation anesthesia with desflurane and a total intravenous anesthesia (TIVA) with propofol and reminfentanil when PEEP was applied in patients undergoing tympanoplasty.
  
  
  METHODS
  Forty-six patients with a scheduled tympanoplasty were enrolled and the patients were divided in two study groups. Desflurane was used as an inhalation anesthetic in group 1 (n = 22), while TIVA with propofol and remifentanil was used in group 2 (n = 24). PEEP was applied by 5 cmH2O in both groups and an ambient temperature was maintained at 22-24℃ during surgery. The core temperature and the difference of skin temperature between forearm and fingertip were monitored for about 180 minutes before and after the induction of general anesthesia.
  
  
  RESULTS
  The final core temperature was significantly higher in group 2 (35.4 ± 0.7℃) than in group 1 (34.9 ± 0.5℃). Peripheral thermoregulatory vasoconstriction was found in 5 subjects (23%) in group 1 and in 21 subjects (88%) in group 2. The time taken for reaching the thermoregulatory vasoconstriction threshold was 151.4 ± 19.7 minutes in group 1 and 88.9 ± 14.4 minutes in group 2.
  
  
  CONCLUSIONS
  When PEEP will be applied, anesthesia with TIVA may have more advantages in core temperature preservation than an inhalation anesthesia with desflurane.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Chosun University School of Medicine, Gwangju, Korea.
authors.forename: Ki Tae
authors.initials: KT
authors.lastname: Jung
authors.affiliation: Department of Anesthesiology and Pain Medicine, Chosun University School of Medicine, Gwangju, Korea.
authors.forename: Sang Hun
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Anesthesiology and Pain Medicine, Chosun University School of Medicine, Gwangju, Korea.
authors.forename: Hyun Young
authors.initials: HY
authors.lastname: Lee
authors.affiliation: Department of Anesthesiology and Pain Medicine, Chosun University School of Medicine, Gwangju, Korea.
authors.forename: Jong Dal
authors.initials: JD
authors.lastname: Jung
authors.affiliation: Department of Anesthesiology and Pain Medicine, Chosun University School of Medicine, Gwangju, Korea.
authors.forename: Byung Sik
authors.initials: BS
authors.lastname: Yu
authors.affiliation: Department of Anesthesiology and Pain Medicine, Chosun University School of Medicine, Gwangju, Korea.
authors.forename: Kyung Joon
authors.initials: KJ
authors.lastname: Lim
authors.affiliation: Department of Anesthesiology and Pain Medicine, Chosun University School of Medicine, Gwangju, Korea.
authors.forename: Keum Young
authors.initials: KY
authors.lastname: So
authors.affiliation: Department of Anesthesiology and Pain Medicine, Chosun University Hospital, Gwangju, Korea.
authors.forename: Ju Young
authors.initials: JY
authors.lastname: Lee
authors.affiliation: Department of Anesthesiology and Pain Medicine, Chosun University School of Medicine, Gwangju, Korea.
authors.forename: Tae Hun
authors.initials: TH
authors.lastname: An
keywords: Desflurane; Inhalation anesthesia; Intravenous anesthesia; Positive end expiratory pressure; Thermoregulation; Vasoconstriction
references.citation: Med Sci Sports Exerc. 2008 Dec;40(12):2055-62
references.pmid: 18981944
references.citation: Anesthesiology. 1995 May;82(5):1169-80
references.pmid: 7741292
references.citation: Best Pract Res Clin Anaesthesiol. 2008 Dec;22(4):627-44
references.pmid: 19137807
references.citation: Anesth Analg. 1999 Apr;88(4):921-4
references.pmid: 10195549
references.citation: Br J Anaesth. 2003 Jan;90(1):32-8
references.pmid: 12488375
references.citation: Korean J Anesthesiol. 2011 Oct;61(4):302-7
references.pmid: 22110883
references.citation: J Clin Anesth. 2006 Mar;18(2):87-95
references.pmid: 16563324
references.citation: Br J Anaesth. 2005 Jan;94(1):74-9
references.pmid: 15486003
references.citation: Anesthesiology. 1995 Dec;83(6):1205-11
references.pmid: 8533913
references.citation: Anesthesiology. 1995 Aug;83(2):293-9
references.pmid: 7631951
references.citation: J Cardiothorac Vasc Anesth. 1997 Feb;11(1):54-7
references.pmid: 9058221
references.citation: Anesthesiology. 2008 Aug;109(2):318-38
references.pmid: 18648241
references.citation: Korean J Anesthesiol. 2009 May;56(5):525-530
references.pmid: 30625783
references.citation: Br J Anaesth. 2005 Apr;94(4):536-41
references.pmid: 15708868
references.citation: Korean J Anesthesiol. 2009 Dec;57(6):704-708
references.pmid: 30625952