2008, Number 4
<< Back Next >>
An Med Asoc Med Hosp ABC 2008; 53 (4)
Post anesthetic shivering: Prevention and management
Quintero M, Ortega J, Rionda E, Jiménez A, Berrocal M, Luna P
Language: Spanish
References: 47
Page: 195-201
PDF size: 153.18 Kb.
ABSTRACT
Postanesthetic shivering is one of the most common causes of discomfort in the postanesthetic care unit after general anesthesia. It occurs in 40% of the cases, most of the time preceded by perioperative hypothermia. This article will dwell upon postanesthetic shivering pathophysiology, as well as preventive measures and treatment by physical and pharmacological means.
REFERENCES
Sessler DI, Rubinstein EH, Moayeri A. Physiological responses to mild perianesthetic hypothermia in humans. Anesthesiology 1991; 75: 594-610.
Crossley AW. Six months of shivering in a district general hospital. Anesthesia 1992; 47: 845-848.
Alfonsi P. Postanesthesia shivering: Epidemiology, pathophysiology and approaches to prevention and management. Minerva Anesthesiol 2003; 69: 438-441.
Horn EP. Late intraoperative clonidine administration prevents postanesthetic shivering after total intravenous or volatile anesthesia. Anesth Analg 1997; 84: 613-617.
Pehl U. Properties of spinal neuronal thermosensitivity in vivo and in vitro. Ann N Y Acad Sci 1997; 813: 138-145.
Bhatttacharya P. Post anaesthesia shivering: A review. Indian J Anesth 2003; 47 (2): 88-93.
Sessler DI. Central thermoregulatory inhibition by general anesthesia. Anesthesiology 1991; 75: 557-559.
Kurtz A, Sessler DI. Thermoregulatory response thresholds during spinal anesthesia. Anesth Analg 1993; 77: 721-726.
Ozaki M, Kurtz A. Thermoregulatory thresholds during epidural and spinal anesthesia. Anesthesiology 1994; 81: 282-288.
Sessler DI. Shivering during epidural anesthesia. Anesthesiology 1990; 72: 816-821.
Giesbrecht GG, Sessler DI, Mekjavic IB, Schroeder M, Bristow GW. Treatment of immersion hypothermia by direct body-to body contact. J Appl Physiol 1994; 76: 2373-2379.
Hori T, Katafuchi T. Cell biology and the functions of thermosensitive neurons in the brain. Prog Brain Res 1998; 115: 9-23.
De Witte J, Sessler DI. Perioperative shivering: Pathophysiology and pharmacology. Anesthesiology 2002; 96: 467-484.
Frank SM. The Catecholamine, cortisol and hemodynamic responses to mild perioperative hypothermia: A randomized clinical trial. Anesthesiology 1995; 82: 83-93.
Frank SM. Perioperative maintenance of normothermia reduces the incidence of morbid cardiac events: A randomized clinical trial. JAMA 1997; 277: 1127-1134.
Israel DJ. Synchronized slow-amplitude modulations in the electromyograms of shivering muscles. J Apl Physiol 1989; 66: 2358-2363.
Panzer O. Shivering and shivering-like tremor during labour with and without epidural analgesia. Anesthesiology 1999; 89: 878-886.
Krenzischek D. Forced air warming vs routine termal care and core temperature measurement sites. J Post Anesth Nurs 1995; 10: 69-77.
Sessler DI, Schoroder M. Heat loss in humans covered with cotton hospital blankets. Anesth Analg 1993; 77: 73-77.
Sessler DI, McGuire J, Hynson J, Moayeri A, Heier T. Thermoregulatory vasoconstriction during isoflurane anesthesia minimally decreases cutaneous heat loss. Anesthesiology 1992; 76 (5): 670-675.
Buggy DJ, Crossley AW. Thermoregulation, mild perioperative hypothermia and postanaesthetic shivering. Br J Anaesth 2000; 84 (5): 615-628.
Sessler DI. Complications and treatment of mild hypothermia. Anesthesiology 2001; 95 (2): 531-543.
Morris RH. Influence of ambient temperature on patient temperature during intraabdominal surgery. Ann Surg 1971; 173 (2): 230-233.
Roe CF. Effect of bowel exposure on body temperature during surgical operations. Am J Surg 1971; 122 (1): 13-15.
Borms SF, Engelen SLE, Himpe DGA, Suy MR, Theunissen WJH. Bair Hugger forced-air warming maintains normothermia more effectively than Thermo-Lite insulation. J Clin Anesth 1994; 6: 303-307.
Ouellette RG. Comparison of four intraoperative warming devices. AANA J 1993; 61: 394-396.
Krenzischek DA, Frank SM, Kelly S. Forced-air warming versus routine thermal care and core temperature measurement sites. J Post Anesth Nurs 1995; 10: 69-78.
Gendron F. «Burns» occurring during lengthy surgical procedures. J Clin Engineer 1980; 5: 20-26.
Gendron FG. Unexplained patient burns: Investigating iatrogenic injuries. Brea, Quest Publishing, 1988.
Crino MH, Nagel EL. Thermal burns caused by warming blankets in the operating room. Anesthesiology 1968; 29: 149-151.
Cheney FW et al. Burns from warming devices in anesthesia: A closed claims analysis. Anesthesiology 1994; 80: 806-810.
Sessler DI, Moayeri A. Skin-surface warming: Heat flux and central temperature. Anesthesiology 1990; 73: 218-224.
Zink RS, Iaizzo PA. Convective warming therapy does not increase the risk of wound contamination in the operating room. Anesth Analg 1993; 76: 54-62.
Negishi C, Hasegawa K, Mukai S, Nakagawa F, Ozaki M, Sessler DI. Resistive-heating and forced-air warming are comparably effective. Anesthesia & Analgesia 2003; 96 (6): 1683-1687.
Sessler DI. Consequences and treatment of perioperative hypothermia. Anesth Clin North Am 1994; 12: 425-456.
Bickler P, Sessler DI. Efficiency of airway heat and moisture exchangers in anesthetized humans. Anesth Analg 1990; 71: 415-418.
Deriaz H, Fiez N, Lienhart A. Influence d’un filtre hygrophobe ou d’un humidificateur-réchauffeur sur l’hypothermie peropératoire. Ann Fr Anesth Réanim 1992; 11: 145-149.
Sellden E. Augmented thermic effect of amino acids under general anaesthesia: A mechanism for prevention anaesthesia-induced hypothermia. Clin Sci 1994; 86: 611-618.
Sellden E, Branstrom R, Brundin T. Augmented thermic effect of amino acids under general anaesthesia occurs predominantly in extra-splanchnic tissues. Clin Sci 1996; 91: 431-439.
Sellden E, Lindahl SG. Postoperative nitrogen excretion after amino acid-induced thermogenesis under anesthesia. Anesth Analg 1998; 87: 641–646.
Crossley AW. Peri-operative shivering. Anaesthesia 1992; 47: 193-195.
Delaunay L, Bonnet F, Liu N. Clonidine comparably decreases the thermoregulatory thresholds for vasoconstriction and shivering in humans. Anesthesiology 1993; 79: 470-474.
Talke P, Tayefesh F. Dexmedetomidine does not alter the sweating threshold, but comparably and linearly decreases vasoconstriction and shivering threshold. Anesthesiology 1997; 87: 835-841.
Joris J, Banache M, Bonnet F. Clonidine and ketanserin both are effective treatment for postanesthetic shivering. Anesthesiology 1993: 79: 532-539.
Rosa G, Pinto G. Control of postanesthetic shivering with neofam hydrochloride in mildly hypothermic patients after neurosurgery. Acta Anesthesiol Scand 1995: 39: 90-95.
Powell RM, Buggy DJ. Ondansetron given before induction of anesthesia reduces shivering after general anesthesia. Anesth Analg 2000; 90: 1423-1427.
Steding-Lindberg G, Moran D, Shapiro Y. How significant is magnesium in thermoregulation? J Basic Clin Physiol Pharmacol 1998; 9: 73-85.