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Age-related decrease in toe-thumb temperature difference with lumbar epidural anaesthesia

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With lumbar epidural anaesthesia, big toe skin temperature increases and is associated with a compensatory decrease of thumb temperature. The purpose of the present study was to examine whether thumb-big toe temperature differences were affected by age. Following the attachment of temperature probes at the digital pad of the right big toe and the right thumb, lumbar epidural anaesthesia at L2/3 was performed in 54 patients with 10 ml lidocaine 1.5%. Big toe and thumb skin temperatures were measured continuously and recorded every minute. Fifteen minutes after epidural injection, the toe temperature increased 6.3 ± 2.1° C (ΔF) from the control value, 29.4 ± 2.2° C, and the thumb temperature decreased −1.5 ± 1.0 ° C (ΔH) from the control value, 31.6 ± 2.8° C. Regression coefficient between ΔT15 (toe-thumb skin temperature 15 min after epidural injection) and age was: Y= −0.7X + 8.95 (r = 0.35, P < 0.01; Y = ΔT15, X = age). The ratio of ΔH to ΔF and age was expressed as: Y = 0.51X − 46.57 (r = 0.41, P < 0.01: Y = ΔH/ΔF, X = age). It is concluded that, in lumbar epidural anaesthesia, the decrease of the thumb skin temperature is reduced with aging.


Pendant l’anesthésie épidurale lombaire, le température du gros orteil augmente et est associée avec une baisse compensatoire de la température du pouce. Cette étude vise à évaluer si les différences de température orteil-pouce sont affectées par l’âge. Après la mise en place de la sonde de température sur la pulpe du gros orteil et du pouce droits, une épidurale lombaire à L2/3 est réalisé chez 54 patients avec 10 ml de lidocaïne 1,5%. Les températures cutanées du gros orteil et du pouce sont mesurée en continu et enregistrées à la minute. Quinze minutes après l’injection épidurale, la température du gros orteil augmente de 6,3 ± 2,1° C (ΔF) comparativement aux valeurs de contrôle, 29,4 ± 2,2° C, et la température du pouce diminue de −1,5 ± 1,0° C (ΔH) comparativement aux valeurs de contrôle, 31,6 ± 2,8° C. Le coefficient de régression entre ΔT15 (la température cutanée orteil-pouce 15 min après l’injection épidurale) et l’âge est: Y = −0,07X + 8,95 (r = 0,35, P < 0,01: Y = ΔT15, X = âge). La relation de ΔH à ΔF avec l’âge s’exprime ainsi: Y = 0,51X − 46,57 (r = 0,41, P < 0,01: Y = ΔH/ΔF, X = âge). On conclut que sous anesthésie épidurale que la baisse de la température cutanée du pouce diminue avec l’âge.


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Correspondence to Shigehito Sato.

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Sato, S., Okubo, N., Yamashita, S. et al. Age-related decrease in toe-thumb temperature difference with lumbar epidural anaesthesia. Can J Anaesth 41, 579 (1994).

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Key words

  • scage factors
  • anaesthetic technique: epidural
  • anaesthetics, local: lidocaine
  • temperature: skin