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February 6, 1967

Inadvertent Hypothermia With Metabolic Acidosis and Circulatory Depression

Author Affiliations

From the Department of Anesthesia, University Hospitals, University of Iowa, Iowa City.

JAMA. 1967;199(6):411-412. doi:10.1001/jama.1967.03120060109019

A 41/2-year-old white girl with tetrology of Fallot was admitted to the hospital because of persistent constipation and an abdominal mass of fluctuating size. One year prior to admission she had undergone a Brock transventricular pulmonary valvotomy, with considerable benefit. Interval cyanosis and squatting were now limited to periods of exertion.

The preoperative workup revealed an abdominal mass, suspected to be a tubular duplication of the colon, and absence of the left kidney. Laparotomy was scheduled following bowel preparation with succinylsulfathiazole (Sulfasuxidine). Premedication consisted of pentobarbital, 60 mg; morphine sulfate, 2 mg; and scopolamine, 0.2 mg. Induction was achieved uneventfully with cyclopropane and oxygen, followed by a combination of nitrous oxide, oxygen, and halothane. An endotracheal catheter was inserted easily and connected to a Norman T-piece with reservoir bag. Anesthesia was maintained with a combination of nitrous oxide and oxygen (3.5:3.5 liters/min) and halothane (0.5% to 1.5%) added as