Expert: Ronald Levy, M.D. - 10/2/2009

Question
Some 10 years ago, my wife had surgery under general anesthesia and in post-op she was noted as hypothermic with core temperature of 92 degrees.  The possibility of adrenal insufficiency was entertained by the anesthesia staff and she was given 125 mg of Solu-Medrol IV to be repeated at six hour intervals.  Endocrinology was then consulted, but in the clinical impression of the Endocrinologist the cause was probably not adrenal insufficiency and a glucocorticoid therapy was withheld after the first dose.  My wife's temperature rose rapidly to 98.5 within four hours postoperatively with just conservative blanket warming.  Prior to discharge, she was again seen by the Endocrinologist who concluded that the "hypothermic episode was of unknown etiology, probably related to anesthesia exposure."

My wife is now scheduled for dental surgery under general anesthesia and I have provided at the dental surgeon with my wife's Operative Report, Endocrinology Consultation Report and Discharge Report.  Unfortunately, the only details on the Anesthesia administered was the name of the doctor and the word "General".  The hospital does not appear to have any additional details from the operation regarding the actual anesthesia agent, dosage or nature of administration.  Barring such a report, can you provide any cautionary advice regarding my wife's future general anesthesia?

Answer
None is really needed. It is not unusual (depending on the surgery) for body temperature to drop. If the procedure is long, is intrabdominal, the patient is given lots of IV fluid, etc, this can cause hypothermia. Nowadays we try to warm everything (the room, the gases, IV fluids, etc) so hypothermia is less of an issue. Furthermore, for dental surgery, this is never an issue. I agree this does not sound like an endocrine problem so I don't think there is anything to worry about.

Ronald Levy, MD
Professor of Anesthesiology
UTMB-Galveston