Anaesthesia in adverse climates

Abstract

While civilization and technological advances provide ever greater control over the environment, so does mankind’s ability to travel in increasing numbers to parts where the climate may be adverse. Indeed, disasters may be man-made, as well as naturally occurring. Thermoregulation is important in cold climates and hypothermia causes profound physiological changes, which affect anaesthesia. Heat loss must be minimized during anaesthesia in the cold and it will almost always be essential to provide some heating for the operating room. The cold may cause difficulties with the vaporization of volatile anaesthetic agents. At altitude, there are the twin problems of cold and reduced atmospheric pressure. Again, these factors will affect both physiological and equipment function adversely. Heat and high humidity also affect both patient physiology and the functioning and life expectancy of anaesthetic equipment in use and storage. Hyperpyrexia is a particular hazard in the unacclimatized and there is an increased requirement for fluid replacement.