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Persistent Hypothermia and Excessive Sweating Following Intrathecal Morphine Administration in a Teenage Boy: A Case Report

dc.contributor.authorFerraz, S
dc.contributor.authorCaria, T
dc.contributor.authorDa Silva, AV
dc.contributor.authorCandeias, MJ
dc.contributor.authorCenicante, T
dc.date.accessioned2018-08-28T11:00:39Z
dc.date.available2018-08-28T11:00:39Z
dc.date.issued2018-02
dc.description.abstractINTRODUCTION: Opioids are used intrathecally to manage surgical pain. There are few reports of hypothermia after spinal morphine injection, none in the pediatric population. We present a teenager's case of mild hypothermia. CASE PRESENTATION: A 15-year-old boy was scheduled for elective abdominal laparotomy. General anesthesia was combined with spinal anesthesia, using levobupivacaine and morphine. In the recovery room, he presented a decreased tympanic temperature (34.4°C) associated with excessive sweating, hyperglycemia, and complained of feeling hot. All other vital signs were normal. It was decided to maintain clinical vigilance and hourly monitoring of temperature and glycaemia values. Despite active warming, he remained hypothermic for 16 hours, with gradual remission of symptoms and normalization of glycemic values. It is unknown how intrathecal morphine causes hypothermia. The most viable hypothesis is its effect on the hypothalamus. In our case the most probable causes of post anesthesia hypothermia were excluded; therefore, we can admit that the cause of hypothermia was the spinal administration of morphine. Some reports used naloxone and lorazepam successfully. In our report, they disappeared spontaneously 16 hours later, which corroborates our diagnosis. CONCLUSIONS: Children undergoing subarachnoid block with with intrathecal morphine may develop a disruption on thermoregulation, leading to a resistant postoperative hypothermia associated with excessive sweating.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationAnesth Pain Med. 2018 Feb 21;8(1):e66724pt_PT
dc.identifier.doi10.5812/aapm.66724pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/3042
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.subjectHypothermiapt_PT
dc.subjectAnesthesiapt_PT
dc.subjectMorphinept_PT
dc.subjectPediatric Anesthesia, Spinalpt_PT
dc.subjectCase Reportpt_PT
dc.subjectHDE ANSpt_PT
dc.subjectHDE CIR PEDpt_PT
dc.titlePersistent Hypothermia and Excessive Sweating Following Intrathecal Morphine Administration in a Teenage Boy: A Case Reportpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.issue1pt_PT
oaire.citation.startPagee66724pt_PT
oaire.citation.volume8pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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