RA-UK Project Grant

The successful applicant for the RA UK Project Grant was:

Dr Loukia Tsaprouni

University of Bedfordshire

Do cyclooxygenase inhibitors decrease human core temperature during exposure to operating room temperatures? Implications for hypothermia and pre-emptive analgesia


Scientific Abstract

Inadvertent perioperative hypothermia (core temperature ≤ 35°C) is common in patients undergoing regional anaesthesia because it lowers the core temperature threshold required for thermogenesis. Perioperative hypothermia carries many physiological side-effects which are associated with post-operative morbidity. Compared with normothermia, the relative risk of impaired wound healing and cardiac disorders is 3.25 and 4.49, respectively. The use of cyclooxygenase (COX) inhibitors in pre-emptive/preventative analgesia may exacerbate these reductions in core temperature and alter blood coagulation status, decreasing patient safety and affecting hospital resources. To evaluate the safety of COX inhibitors in the operative environment, 10 healthy participants will be exposed to an operating room temperature dressed in a surgical gown for 2 hours following administration of aspirin (COX-1 inhibitor), celecoxib (COX-2) inhibitor, and nothing (control). Core temperature and shivering intensity (via electromyography) will be monitored continuously. Blood coagulation status will be assessed through quantification of thrombin-anti thrombin complex and fibrinogen (sampled pre-exposure, 60 min, 120 min). The findings will allow anaesthetists to make more informed judgements about whether it is safe to use COX inhibitors for pre-emptive analgesia. This will increase patient safety and potentially reduce hospital stay duration.