• The Korean Journal of Pain
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• v.26 no.4
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• pp.379-386
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• 2013

Background: Shivering related to spinal anesthesia may interfere with monitoring and is uncomfortable. The aim of the present study was to investigate low-dose intrathecal meperidine for the prevention of shivering after induction of spinal anesthesia in parturients with cesarean section. Methods: This was a prospective randomized, double-blind, placebo-controlled trial including 100 parturients, of American Society of Anesthesiologists (ASA) physical status I or II, scheduled for elective cesarean section under spinal anesthesia who were randomly assigned to a meperidine (0.2 mg/kg) plus hyperbaric lidocaine (5%, 75 mg, n = 50; group M) group or a placebo plus hyperbaric lidocaine (5%, 75 mg, n = 50; group L) group. Demographic and surgical data, adverse events, and the mean intensity for each parturient were assessed during the entire study period by a blinded observer. Results: There were no significant differences between the two study groups regarding the demographic and surgical data (P > 0.05). The incidence of shivering during the entire study period significantly decreased in the group of parturients who received intrathecal meperidine (P = 0.04). There were no significant differences in nausea and vomiting between the two groups. Conclusions: Low-dose intrathecal meperidine (10 mg) is safe and effective in reducing the incidence and severity of shivering associated with spinal anesthesia in parturients with cesarean section.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.22 no.3
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• pp.287-296
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• 2015

Purpose: The purpose of this study was to examine the effects of forced air warming on intraoperative and postoperative body temperature, postoperative shivering and pain in patients undergoing laparoscopic cholecystectomy. Methods: A quasi-experimental design with nonequivalent control group was utilized. Fifty eight patients scheduled for laparoscopic cholecystectomy were recruited and assigned to the experimental group (n=29) or control group (n=29). For the experimental group, forced air warming was applied from right after induction and up to one hour after surgery. Body temperature, shivering score and pain score were measured in both groups at 15 minute intervals. Data were collected from September, 2013 to April, 2014. Data were analyzed using t-test, Bonferroni test and repeated measures ANOVA. Results: The experimental group showed higher body temperature than the control group during surgery. After surgery the experimental group showed higher body temperature, lower shivering and less pain compared to the control group. Conclusion: Results show that forced air warming is effective in enhancing body temperature and reducing shivering and pain. Therefore, forced air warming is recommended as an operative nursing intervention.

• The Korean Journal of Pain
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• v.28 no.1
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• pp.39-44
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• 2015

Background: Postoperative nausea and vomiting (PONV), postanesthetic shivering and pain are common postoperative patient complaints that can result in adverse physical and psychological outcomes. Some antiemetics are reported to be effective in the management of postoperative pain and shivering, as well as PONV. We evaluated the efficacy of dexamethasone added to ramosetron on PONV, shivering and pain after thyroid surgery. Methods: One hundred and eight patients scheduled for thyroid surgery were randomly allocated to three different groups: the control group (group C, n = 36), the ramosetron group (group R, n = 36), or the ramosetron plus dexamethasone group (group RD, n = 36). The patients were treated intravenously with 1 and 2 ml of 0.9% NaCl (group C); or 2 ml of 0.15 mg/ml ramosetron plus 1 ml of 0.9% NaCl (group R); or 2 ml of 0.15 mg/ml ramosetron plus 1 ml of 5 mg/ml dexamethasone (group RD) immediately after anesthesia. Results: Incidence of nausea and the need for rescue antiemetics, verbal rating scale (VRS) 1 hour pain value, ketorolac consumption, and incidence of shivering were significantly lower in group R and group RD, than in group C (P < 0.05). Moreover, these parameters were significantly lower in group RD than in group R (P < 0.05). Conclusions: Combination of ramosetron and dexamethasone significantly reduced not only the incidence of nausea and need for rescue antiemetics, but also the VRS 1 hour pain value, ketorolac consumption, and the incidence of shivering compared to ramosetron alone in patients undergoing thyroid surgery.

• Journal of Korean Clinical Nursing Research
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• v.17 no.2
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• pp.192-203
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• 2011

Purpose: The purpose of this study was to compare the body temperature (BT), blood pressure (BP) and shivering in patients undergoing operation under general anesthesia between the heated humidification circuit tube (HHCT) group and the non-HHCT group. Methods: Data were extracted from the participants' medical records from September 1st to December 30th, 2009. The HHCT group consisted of 50 cases who were applied with heated and humidified gas via a specially designed circuit under general anesthesia. The HHCT which was adjusted at $41^{\circ}C$ was applied from induction of general anesthesia to extubation. In comparison, the non-HHCT group consisted of 50 cases who were applied with gas through standard breathing circuit without heat and humidification. Collected data were analyzed by $x^2$ test, t-test and repeated measures ANOVA. Results: The BT and shivering were significantly different between two groups (p<.001). But the BP was was not signigicantly different between the HHCT group and the non-HHCT group. Conclusion: The application of heated and humidified gases to patients under general anesthesia was effective in preserving the body temperature and reducing the shivering.

• Animal cells and systems
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• v.5 no.1
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• pp.31-35
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• 2001

Temperate-resident bats exhibit a circadian cycle of torpor and arousal In summer. The physiological role and selective advantage of torpor as an energy saving mechanism have been received much attention by hibernation biologists. However, despite the significance of the recovering euthermic function, the arousal process and mechanism in these animals have been poorly addressed. In this study, we investigated thermogenic and motor activities of a local bat species Murina leucogaster during arousal by simultaneously examining oxygen consumption rate, body temperature ($T_b$) and pectoral electromyography (EMG). We found that Tb of the torpid bats (12-14$^{\circ}C$) was augmented slowly by nonshivering mechanism during the initial awakening phase. The pectoral shivering, gauged by EMG activity, occurred between 17$^{\circ}C$ and 38$^{\circ}C$. Over this Tb range of shivering, heat was produced at a rate of 0.145 kcal $kg^{-1}\;min^{-1}$ to raise 1$^{\circ}C$ $T_b$ per min. Shivering was most intensive at 30-35$^{\circ}C$ where both EMG amplitude and spike frequency were the highest. Activation of the pectoral myofibers seemed to be controlled in a manner that motor units were recruited from smaller to larger sizes, with greater synchronization, as muscle shivering became intensive with increasing $T_b$.

• Journal of Korean Academy of Nursing
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• v.47 no.4
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• pp.456-466
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• 2017

Purpose: This study was designed to determine the effects of pre-warming on core body temperature (CBT) and hemodynamics from the induction of spinal anesthesia until 30 min postoperatively in surgical patients who undergo total hip replacement under spinal anesthesia. Our goal was to assess postoperative shivering and inflammatory response. Methods: Sixty-two surgical patients were recruited by informed notice. Data for this study were collected at a 1,300-bed university hospital in Incheon, South Korea from January 15 through November 15, 2013. Data on CBT, systemic blood pressure (SBP), and heart rate were measured from arrival in the pre-anesthesia room to 3 hours after the induction of spinal anesthesia. Shivering was measured for 30 minutes post-operatively. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were measured pre-operatively, and 1 and 2 days postoperatively. The 62 patients were randomly allocated to an experimental group (EG), which underwent pre-warming for 30 minutes, or a control group (CG), which did not undergo pre-warming. Results: Analysis of CBT from induction of spinal anesthesia to 3 hours after induction revealed significant interaction between group and time (F=3.85, p=.008). In addition, the incidence of shivering in the EG was lower than that in the CG ($x^2=6.15$, p=.013). However, analyses of SBP, heart rate, CRP, and ESR did not reveal significant interaction between time and group. Conclusion: Pre-warming for 30 minutes is effective in increasing CBT 2 and 3 hours after induction of spinal anesthesia. In addition, pre-warming is effective in decreasing post-operative shivering.

• Journal of Dental Anesthesia and Pain Medicine
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• v.15 no.4
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• pp.193-200
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• 2015

Background: During head and neck surgery including orthognathic surgery, mild intraoperative hypothermia occurs frequently. Hypothermia is associated with postanesthetic shivering, which may increase the risk of other postoperative complications. To improve intraoperative thermoregulation, devices such as forced-air warming blankets can be applied. This study aimed to evaluate the effect of supplemental forced-air warming blankets in preventing postanesthetic shivering. Methods: This retrospective study included 113 patients who underwent orthognathic surgery between March and September 2015. According to the active warming method utilized during surgery, patients were divided into two groups: Group W (n = 55), circulating-water mattress; and Group F (n = 58), circulating-water mattress and forced-air warming blanket. Surgical notes and anesthesia and recovery room records were evaluated. Results: Initial axillary temperatures did not significantly differ between groups (Group $W=35.9{\pm}0.7^{\circ}C$, Group $F=35.8{\pm}0.6^{\circ}C$). However, at the end of surgery, the temperatures in Group W were significantly lower than those in Group F ($35.2{\pm}0.5^{\circ}C$ and $36.2{\pm}0.5^{\circ}C$, respectively, P = 0.04). The average body temperatures in Groups W and F were, respectively, $35.9{\pm}0.5^{\circ}C$ and $36.2{\pm}0.5^{\circ}C$ (P = 0.0001). In Group W, 24 patients (43.6%) experienced postanesthetic shivering, while in Group F, only 12 (20.7%) patients required treatment for postanesthetic shivering (P = 0.009, odds ratio = 0.333, 95% confidence interval: 0.147-0.772). Conclusions: Additional use of forced-air warming blankets in orthognathic surgery was superior in maintaining normothermia and reduced the incidence of postanesthetic shivering.

• Journal of East-West Nursing Research
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• v.26 no.2
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• pp.149-156
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• 2020

Purpose: The purpose of this study was to identify the effects of the heated-humidified breathing circuit applied on the body temperature, shivering, and thermal comfort of general anesthesia patients. Methods: The participants were patients who received general anesthesia at University Hospital K located in City B, with 25 patients in the experimental group and 25 patients in the control group. The period of this study was from Mar 19 to Apr 26, 2019. The experimental equipment included a heated-humidified breathing circuit, which connects the intubation tube with the anesthesia machine for mechanical ventilation after airway intubation in general anesthesia patients. Results: The body temperature, shivering, and thermal comfort after surgery were significantly different between the two groups (p<.001). However, the body temperature during surgery was slightly different between the experimental group and the control group. Conclusion: A heated-humidified breathing circuit may be actively used in a warming method to prevent the hypothermia of general anesthesia patients.

• Korean Journal of Adult Nursing
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• v.20 no.1
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• pp.135-148
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• 2008

Purpose: This study compared the effects of forced air warming and radiant heating on body temperature and shivering of patients with postoperative hypothermia. Methods: The quasi-experimental study was conducted with two experimental groups who had surgery under general anesthesia; 20 patients of group 1 experimented with the Bair Hugger as a forced air warming and 20 patients of group 2 experimented with the Radiant heater. The study was performed from July 3 to August 31, 2006 in a recovery room of an university hospital in a city. The effects of the experiment were measured by postoperative body temperature and chilling score at arrival and after every 10 minutes. The data were analyzed by t-test or ${\chi}^2$-test, repeated measures ANCOVA using SPSS/WIN 12.0. Results: The mean body temperature showed differences between the Bair Hugger group and Radiant Heater group at 40 minutes(F=-2.579, p=.034), 50minutes(F=-2.752, p=.027), and 60 minutes(F=-2.470, p=.047) after arrival to the recovery room. So, hypothesis 1 was partially accepted. The mean score of shivering showed differences between the Bair Hugger group and the Radiant Heater group, but it had no significant meaning. Hypothesis 2 was not accepted. Conclusion: We need more study to explore the effects and side effects of heating modalities to select a more effective heat treatment. The efficiency of heat modalities with regards to cost benefit, time consumption, and patients' discomfort such as burns should be considered.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.21 no.2
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• pp.112-122
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• 2014

Purpose: The purpose of this study was to examine the effects on body temperature, shivering, and perceived thermal comfort of web-based evidence-based practice guideline for patients undergoing gastrectomy. Methods: Eighty patients scheduled for gastrectomy were recruited and assigned to the control or experimental group by sequential order. Before collecting data from the experimental group, a systematic educational program on evidence-based guidelines was provided to the nurses as well anesthesiologists. Data were analyzed using t-test and repeated measured ANOVA. Results: The experimental group showed higher body temperature from the induction of anesthesia until four hours after surgery compared to the control group. In addition, the levels of thermal comfort as well as satisfaction with thermal management were significantly higher in the experiment group. Conclusion: Use of evidence-based guidelines was effective in maintaining body temperature, lowering sensitivity to shivering, and promoting perceived thermal comfort. Therefore, adoption of evidence-based interventions in nursing practice is recommended.