Postanaesthetic shivering. Epidemiology, pathophysiology and approaches to prevention and management.

Abstract:

:Postanaesthetic shivering is one of the leading causes of discomfort for patients recovering from general anesthesia. During EMG records, the distinguishing factor from shivering in fully awake patients is the existence of clonus similar to that recorded in patients with spinal cord transection. They coexist with the classic waxing and waning signals associated with cutaneous vasoconstriction (thermoregulatory shivering). The causes responsible for their appearance primarily include hypothermia, which sets in due to thermoregulation inhibition by anesthetics. However, we also note the existence of shivering associated with cutaneous vasodilatation (non-thermoregulatory shivering) one of the origins of which is postoperative pain. Apart from the discomfort and aggravated pain, postanaesthetic shivering raises metabolic demand proportionally to the solicited muscle mass and the patient's cardiac capacities. No link has been demonstrated between their occurrence and an increase in cardiac morbidity but it is preferable to avoid postanaesthetic shivering since it is oxygen draining. Prevention mainly entails preventing hypothermia by actively rewarming the patient. Postoperative skin surface rewarming is a way of obtaining the threshold shivering temperature while raising the skin temperature and improving the patient's comfort. However, it is less efficient than certain drugs such as meperidine, nefopam or tramadol, which act by reducing the shivering threshold temperature.

journal_name

Minerva Anestesiol

journal_title

Minerva anestesiologica

authors

Alfonsi P

keywords:

subject

Has Abstract

pub_date

2003-05-01 00:00:00

pages

438-42

issue

5

eissn

0375-9393

issn

1827-1596

journal_volume

69

pub_type

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