The current usage of hypothermia in British neurosurgery.

A questionnaire on the current usage of deliberate hypothermia was sent to all members of the Neurosurgical Anaesthetists' Travelling Club in October 1970. Seventy-seven per cent of the members who could be traced, and who where still engaged in neurosurgical practice, replied individually or in combination. Wide variations were revealed in the use of the technique from centre to centre. Virtually no hypothermia is employed in the London hospitals, while the Midland centre and Wessex employ the technique in 15 per cent of major intracranial operations, Glasgow in 20 per cent and Liverpool in 30 per cent. Cooling is most commonly produced with circulating-water blankets. The most popular anaesthetic technique consists of supplementation of nitrous oxide/ oxygen, relaxant anaesthesia, with either halothane or neuroleptanalgesic drugs. Controlled ventilation is almost invariably employed. In addition to routine monitoring of temperature and electrocardiogram, intra-arterial blood pressure recording and central venous pressure measurements are used by thirteen of the thirty-four anaesthetists who regularly employ hypothermia. Shivering during recovery is most commonly treated with chlorpromazine and promazine. Serious cardiac arrhythmias are extremely rare.