Factors Influence Shivering Phenomenon Post Spinal Anesthesia

Ghada  Alnaeli; Sara  Hwisa; Salaheddin  Elmaggoze; Aboajela  Ajaj; Suhila Alkayakh

doi:10.54361/Ljmr18-1.05

Authors

Ghada Rajab Alnaeli Department of Anesthesia Faculty of Medical Technology, Surman, Sabratha University Libya. Author
Sara A Hwisa Vice dean for Scientific Affairs, Faculty of Dentistry and Oral surgery, Surman, Sabratha University Libya. Author
Salaheddin Ali Etomy Elmaggoze Department of Anesthesia Faculty of Medical Technology, Surman, Sabratha University Libya Author
Aboajela Ramadan Ajaj Department of Anesthesia Faculty of Medical Technology, Surman, Sabratha University Libya. Author
Suhila Alkayakh Department of Anesthesia Faculty of Medical Technology, Surman, Sabratha University Libya. Author

DOI:

https://doi.org/10.54361/Ljmr18-1.05

Keywords:

Shivering, Postoperative, Complications, Tramadol, Spinal, Anesthesia

Abstract

Background: Shivering is a prevalent complication encountered by patients following anesthesia. The incidence of shivering after anesthesia can be influenced by factors such as age and the temperature of the operating room. The aim of this study was to compare the occurrence of shivering during surgical procedures among patients who experienced no shivering and those who did. Methodology: data from 60 patients who underwent spinal surgery under anesthesia. We divided them into two groups: 30 without shivering (Group A) and 30 treated with tramadol for shivering (Group B). Results: incidence of shivering among younger patients (<30 years of age). Furthermore, shivering was observed during blood transfusion, and high incidence with patient had undergone a cesarean section (36.7%), in those who received cold liquid during the operating (73.3%), and in those who had not undergone previous surgery (73.3%). Moreover, there were significant correlations between shivering and factors such as age, temperature range during and after the operation (°C), and the condition of the administered liquid during the procedure. Conclusion: the occurrence of post anesthesia shivering in relation to various demographic and procedural factors. The range of age and temperature during and after the operation showed a significant association with the incidence of shivering.

References

National Guideline Alliance (UK). Prevention and management of hypothermia and shivering: Caesarean birth: Evidence review C. London: National Institute for Health and Care Excellence (NICE); 2021.

De Witte J, Sessler DI. Perioperative shivering: physiology and pharmacology. Anesthesiology. 2002;96(2):467-84. DOI: https://doi.org/10.1097/00000542-200202000-00036

Bhatnagar S, Saxena A, Kannan TR, Punj J, Panigrahi M, Mishra S. Tramadol for postoperative shivering: a double-blind comparison with pethidine. Anaesth and intensive care. 2001;29(2):149-54.

Sessler D I. Temperature Monitoring. In: Miller RD, editor. Textbook of Anaesthesia. 7th ed. Churchill Livingstone, Philadelphia.2010: 1533-1556. DOI: https://doi.org/10.1016/B978-0-443-06959-8.00048-0

Eberhart LH, Döderlein F, Eisenhardt G, Kranke P, Sessler DI, Torossian A, Wulf H, Morin AM. Independent risk factors for postoperative shivering. Anesth Analg. 2005;101(6):1849-57. DOI: https://doi.org/10.1213/01.ANE.0000184128.41795.FE

Alneli GR. Anesthesia and pain management drugs used in Libyan hospitals and clinics. Libyan Journal of Medical Research. 2023;17(1):133-45. DOI: https://doi.org/10.54361/ljmr.17-14

Hoshijima H, Takeuchi R, Kuratani N, Nishizawa S, Denawa Y, Shiga T, Nagasaka H. Incidence of postoperative shivering comparing remifentanil with other opioids: a meta-analysis. J Clin Anesth. 2016;32:300-12. DOI: https://doi.org/10.1016/j.jclinane.2015.08.017

Alnaeli GR, Hwisa SA, Alhuwayj KA, Elmaggoze SA. The impact of adding fentanyl to bupivacaine on spinal anesthesia for caesarean. Libyan Journal of Medical Research. 2023;17(2):108-17. DOI: https://doi.org/10.54361/LJM172.11

Bhatnagar S, Saxena A, Kannan TR, Punj J, Panigrahi M, Mishra S. Tramadol for postoperative shivering: a double-blind comparison with pethidine. Anaesth and intensive care. 2001;29(2):149-54. DOI: https://doi.org/10.1177/0310057X0102900209

Alfonsi P. Postanaesthetic shivering. Epidemiology, pathophysiology and approaches to prevention and management. Minerva Anestesiol. 2003;69(5):438-42.

Zhang Y, Wong KC. Anesthesia and postoperative shivering: its etiology, treatment and prevention. Acta Anaesthesiol Sin. 1999;37(3):115-20.

Abdelrahman RS. Prevention of shivering during regional anaesthesia: comparison of Midazolam, Midazolam plus Ketamine, Tramadol, and Tramadol plus Ketamine. Life Sci J 2012; 9: 132-9.

Lopez MB. Postanaesthetic shivering - from pathophysiology to prevention. Rom J Anaesth Intensive Care. 2018; 25: 73-81. DOI: https://doi.org/10.21454/rjaic.7518.251.xum

Xu R, Hu X, Sun Z, Zhu X, Tang Y. Incidence of postoperative hypothermia and shivering and risk factors in patients undergoing malignant tumor surgery: a retrospective study. BMC anesthesiol. 2023;23(1):31. DOI: https://doi.org/10.1186/s12871-023-01991-8

Ferede YA, Aytolign HA, Mersha AT. “The magnitude and associated factors of intraoperative shivering after cesarean section delivery under Spinal anesthesia’’: A cross sectional study. Ann of Med Surg. 2021;72:103022. DOI: https://doi.org/10.1016/j.amsu.2021.103022

Badawy AA, Mokhtar AM. The role of ondansetron in prevention of post-spinal shivering (PSS) in obstetric patients: A double-blind randomized controlled trial. Egyptian Journal of Anaesthesia. 2017;33(1):29-33. DOI: https://doi.org/10.1016/j.egja.2016.12.004

Usta B, Gozdemir M, Demircioglu RI, Muslu B, Sert H, Yaldız A. Dexmedetomidine for the prevention of shivering during spinal anesthesia. Clinics. 2011;66(7):1187-91. Usta B, Gozdemir M, Demircioglu RI, Muslu B, Sert H, Yaldız A. Dexmedetomidine for the prevention of shivering during spinal anesthesia. Clinics (Sao Paulo). 2011 Jul 1;66(7):1187-91. DOI: https://doi.org/10.1590/S1807-59322011000700011

VASSILIEFF, N.; ROSENCHER, N.; SESSLER, D. I.; CONSEILLER, C. Shivering Threshold During Spinal Anesthesia Is Reduced in Elderly Patients. Survey of Anesthesiology.1996. 40(5):p 290. DOI: https://doi.org/10.1097/00132586-199610000-00031

Munday J, Hines S, Wallace K, Chang AM, Gibbons K, Yates P. A systematic review of the effectiveness of warming interventions for women undergoing cesarean section. Worldviews Evid Based Nurs. 2014;11(6):383-93. DOI: https://doi.org/10.1111/wvn.12067

Qi X, Chen D, Li G, Cao J, Yan Y, Li Z, Qiu F, Huang X, Li Y. Risk factors associated with intraoperative shivering during caesarean section: a prospective nested case-control study. BMC anesthesiology. 2022 Dec;22(1):1-0. DOI: https://doi.org/10.1186/s12871-022-01596-7

Rajagopalan S, Mascha E, Na J, Sessler DI. The effects of mild perioperative hypothermia on blood loss and transfusion requirement. Anesthesiology. 2008;108(1):71-7. DOI: https://doi.org/10.1097/01.anes.0000296719.73450.52

Jun JH, Chung MH, Jun IJ, Kim Y, Kim H, Kim JH, Choi YR, Choi EM. Efficacy of forced-air warming and warmed intravenous fluid for prevention of hypothermia and shivering during caesarean delivery under spinal anaesthesia: A randomised controlled trial. Eur J Anaesthesiol. 2019;36(6):442-8. DOI: https://doi.org/10.1097/EJA.0000000000000990

Meghana VS, Vasudevarao SB, Kamath SS. The effect of combination of warm intravenous fluid infusion and forced air warming versus forced air warming alone on maternal temperature and shivering during cesarian delivery under spinal anesthesia. Ann Afr Med.