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Fever during anaesthesia
Authors:Negishi Chiharu  Lenhardt Rainer
Affiliation:Department of Anaesthesia, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan;Outcomes Research™ Institute, Department of Anesthesiology, University of Louisville, 501 East Broadway, Suite 210, Louisville, KY 40202, USA
Abstract:Fever occurs when pyrogenic stimulation activates thermal control centres. Fever is common during the perioperative period, but rare during anaesthesia. Although only a limited number of studies are available to explain how anaesthesia affects fever, general anaesthesia seems to inhibit fever by decreasing the thermoregulatory-response thresholds to cold. Opioids also inhibit fever; however, the effect is slightly less than that of general anaesthesia. In contrast, epidural anaesthesia does not affect fever. This suggests that hyperthermia, which is often associated with epidural infusions during labour or in the post-operative period, may be a true fever caused by inflammatory activation. Accordingly, this fever might be diminished in patients who receive opioids for pain treatment. Post-operative fever is a normal thermoregulatory response usually of non-infectious aetiology. Fever may be important in the host defence mechanisms and should not be routinely treated lest the associated risks exceed the benefits.
Keywords:fever   anaesthesia   volatile anaesthetics   intravenous anaesthetics   opioids   epidural analgesia   temperature   thermoregulation   thermoregulatory threshold   inflammation   cytokines   pyrogen   antipyretic   treatment of fever
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