Hypothermia Following Intra-Thecal Morphine Injection during Cesarean Section a Case Report and Literature Review

Introduction: Perioperative hypothermia is a common phenomenon with a wide differential diagnosis. We present a unique case of hypothermia following cesarean section under spinal anesthesia. Case report: A 32 years old female, first IVF pregnancy with twins, underwent cesarean section under spinal administration of bupivacaine and morphine. About four hours after operation’s end, body temperature was measured at 35.4oC per rectum, which later reached a nadir of 32.8oC, restoring to normal range only after four hours. During the incident, the patient was hemodynamically stable, with vital signs at the normal range. Discussion: This case presents differential diagnoses, the most relevant of which are infection, hypovolemia, endocrinopathy, environmental conditions, iatrogenic causes and the administration of anesthetics. We discuss supporting and contradicting evidence for each relevant diagnosis, reaching a concluding diagnosis of intrathecalmorphine induced hypothermia. Summary: This case highlights the importance of differential diagnosis and temperature follow-up after spinal injection of morphine.