Hyperthermia and Hypothermia During Neurosurgical Procedures
Normal physiologic mechanisms achieve tight control of core body temperature, which is required for normal homeostasis. General anesthesia impairs normal thermoregulatory control, while the OR environment and surgical exposure are predisposing factors for hypothermia. Perioperative hypothermia is associated with increased morbidity from wound infection, coagulopathy, and myocardial ischemia. While there has been interest in brain protective effects of induced mild hypothermia in neurosurgical procedures, it has not been shown to improve outcomes. Some studies have shown improved neurological outcomes in patients who were cooled following ventricular fibrillation cardiac arrest, but more recent data advocate normothermia post-arrest. Hyperthermia, which may be a result of numerous clinical disorders, is detrimental to the injured brain and should be avoided.