Table 3.

Current evidence on drug response change in therapeutic hypothermia

Pharmacological effect	Temperature/subject population	Investigated Drug	Drug response/PD estimates
Muscle relaxant	34.5°C/patients undergoing surgery	Vecuronium [54]	Recovery time↑, duration of action↑
Muscle relaxant	<35, 35–35.9,36–36.9°C/volunteers	Vecuronium [55]	Response↑, equilibration rate↓
Muscle relaxant	34°C/healthy volunteers	Atracurium [26]	Response↑, duration of action↑
Muscle relaxant	34°C/healthy volunteers	Neostigmine [39]	No change in efficacy and duration
Muscle relaxant	30.4°C/neurosurgical patients	Rocuronium[43]	Duration of action↑
Muscle relaxant	31.9°C/neurological patients	D-tubocurarine [55]	Duration of action↑
Volatile anesthetic	34, 31°C/children	Isoflurane [57]	Dose requirement↓ 5.1% per °C. MAC↓
Opiate anesthetic	30°C/dog	Morphine [47]	Hypotension incidence↑
Opiate anesthetic	30°C/guinea pig ileum	Morphine [58]	IC50↓, the affinity to μ-receptor↓
β-adrenoceptor agonist	33°C/rats	Isoproterenol [59]	HR↓, CO↓, SV↓, LV dP/dtmax↓
β2-adrenoceptor agonist	30°C/guinea-pig	Orciprenaline [60]	β1 adrenoceptor sensitivity↑

Abbreviations: MAC: Minimum alveolar concentration; IC50: The half maximal inhibitory concentration, HR: Heart rate; CO: Cardiac output; SV: Stroke volume; LV dp/dtmax: Left ventricle contractility.