Assessment of changes of skin moisture in patients subject to general anesthesia with neurological diseases in an interview

Abstract

OBJECTIVE: Introduction: General anaesthesia is carried out using anaesthetic agents that among others depress the circulatory system and CNS. Central and peripheral thermoregulation occurs, which is due to mild hypothermia as well as changes in skin moisture. An important element of therapy in the perioperative period is adequate intravenous fluid therapy, which affects the final effects of treatment. The aim: Evaluation of skin moisture as a result of changes in central and peripheral thermoregulation during general anaesthesia and evaluation of the hydration status of patients. PATIENTS AND METHODS: Material and methods: The study included 180 patients undergoing general anaesthesia for elective surgery, aged 20-85 years of age. Before general anaesthesia, patients were evaluated for ASA-related risk of anaesthesia (ASA 1 - healthy patients, ASA 2 and 3 - patients with neurological and circulatory disorders). Patients were divided into 2 groups, the study group (90 people) were patients who were given no intravenous fluids before the surgery and the control group (90 patients) were those receiving doses of 500 ml crystalline intravenously one hour before anaesthesia. The research was carried out at the Operational Block of the Provincial Hospital in Tarnobrzeg, from November 2013 to November 2014. Skin moisture was measured using a CM 825 Corneometer: before general anaesthesia, after induction for anaesthesia, 15 min after surgical incision of the skin and after awakening the patient. RESULTS: Results: Both in the test and control groups, statistically significant differences were found in subsequent skin moisture measurements. Pairwise comparisons indicate statistically significant differences between each pair of measurements. In both groups of patients, there is a clear decrease in skin moisture after induction of anaesthesia compared to the measurement performed before general anaesthesia. The skin moisture values are reduced in subsequent measurements, however the difference is much lower. CONCLUSION: Conclusions: 1 Measurement of skin moisture can be used as one of the parameters to assess perioperative stress and changes in body temperature during general anaesthesia, which indirectly determines the functioning of the hypothalamus. 2 By measuring the skin moisture it is possible to indirectly assess the hydration status of patients as well as the decrease of the metabolism during general anaesthesia. 3 The decrease in skin moisture during general anaesthesia is the effect of changes in central and peripheral thermoregulation.