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• W4254090301 abstract "We appreciate the comments by Roth1 regarding our study2 and welcome the opportunity to discuss the issues raised. All women in our study received prophylactic phenylephrine infusion titrated to avoid hypotension, as per standard of care in our institution and as per the study protocol. However, in 4 cases, metaraminol was also administered with temperature decline in these cases ranging from 0.3°C to 1.5°C. Therefore, as we noted, due to individual differences in vasopressor use, only limited exploratory analysis of the secondary outcome of mean arterial pressure was conducted. While there is some limited evidence to suggest that patients receiving phenylephrine may experience higher end of procedure temperatures during orthopedic surgery under general anesthesia,3 more recent evidence from an observational study found that larger doses of phenylephrine resulted in lower (although not hypothermic) maternal temperatures.4 In our study in which all women received phenylephrine infusion, redistribution hypothermia remained clinically significant across both groups. With this conflicting evidence in mind, acknowledging that the physiology is complex and that there is no gold standard measure of vasodilation, it would be valuable for future studies among women receiving neuraxial anesthesia to accurately record the dose of vasopressors, as well as oxytocics, which may also influence maternal perception of heat because of flushing. In response to the comments regarding the measurement of shivering in our study, we confirm that this was not assessed as a “surrogate” outcome for hypothermia. Although we did comment that the intensity and incidence of shivering may indicate the severity of hypothermia, our study also acknowledges that the cause of shivering may be multifactorial. Although we did not measure skin temperature in our study, we noted that thermal comfort did not influence shivering. Judy Munday, PhDSchool of Nursing, Faculty of HealthQueensland University of TechnologyBrisbane, Queensland, Australia[email protected] Sonya Osborne, PhDAustralian Centre for Health Services InnovationSchool of Public Health and Social Work/Faculty of HealthQueensland University of TechnologyBrisbane, Queensland, Australia Patsy Yates, PhDSchool of Nursing, Faculty of HealthQueensland University of TechnologyBrisbane, Queensland, Australia David Sturgess, MBBS, PhDMater Research Institute, University of QueenslandBrisbane, Queensland, Australia Lee Jones, BScEdward Gosden, MScInstitute of Health and Biomedical InnovationQueensland University of TechnologyBrisbane, Queensland, Australia" @default.
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• W4254090301 date "2018-06-01" @default.
• W4254090301 modified "2023-09-26" @default.
• W4254090301 title "In Response" @default.
• W4254090301 cites W2042719837 @default.
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• W4254090301 doi "https://doi.org/10.1213/ane.0000000000002892" @default.
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