Anaesthetic temperature and shivering in epidural anaesthesia

Ponte, J; Collett, Beverly; Walmsley, A.

doi:10.1111/j.1399-6576.1986.tb02480.x

Cited by 39 publications

(8 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There is thus the theoretical possibility that injection of relatively cool (i.e., ambient temperature) local anesthetic into the epidural space might provoke shivering by stimulating local temperature sensors. Consistent with this possibility, the incidence of shivering in pregnant women was reported to be greater when they are given refrigerated epidural anesthetic than when the anesthetic is warmed before injection 165. However, epidural administration of large amounts of ice-cold saline does not trigger shivering in non-pregnant volunteers 166.…”

Section: Thermoregulation During Neuraxial Anesthesiamentioning

confidence: 91%

Temperature Monitoring and Perioperative Thermoregulation

2008

View full text Add to dashboard Cite

Most clinically available thermometers accurately report the temperature of whatever tissue is being measured. The difficulty is that no reliably core-temperature measuring sites are completely non-invasive and easy to use — especially in patients not having general anesthesia. Nonetheless, temperature can be reliably measured in most patients. Body temperature should be measured in patients having general anesthesia exceeding 30 minutes in duration, and in patients having major operations under neuraxial anesthesia. Core body temperature is normally tightly regulated. All general anesthetics produce a profound dose-dependent reduction in the core temperature triggering cold defenses including arterio-venous shunt vasoconstriction and shivering. Anesthetic-induced impairment of normal thermoregulatory control, and the resulting core-to-peripheral redistribution of body heat, is the primary cause of hypothermia in most patients. Neuraxial anesthesia also impairs thermoregulatory control, although to a lesser extant than general anesthesia. Prolonged epidural analgesia is associated with hyperthermia whose cause remains unknown.

show abstract

Section: Thermoregulation During Neuraxial Anesthesiamentioning

confidence: 91%

Temperature Monitoring and Perioperative Thermoregulation

2008

View full text Add to dashboard Cite

show abstract

“…In contrast, other investigators concluded that shivering was primarily caused by a nonthermogenic mechanism. 97,98 A possible detrimental effect of maternal fever on the fetus has been a subject of significant controversy. Macaulay et al 99 monitored intrauterine and fetal scalp temperature in a group of 57 parturients.…”

Section: Fever: Epidural Analgesia and Maternal "Fever"mentioning

confidence: 99%

The febrile parturient: choice of anesthesia

Kuczkowski

2002

Southern African Journal of Anaesthesia and Analgesia

View full text Add to dashboard Cite

The febrile parturient: choice of anesthesia ture and temperature control mechanisms that constantly adjust body temperature, to maintain this level. Fever is defined as an increase in core body temperature above 38 ºC, which is secondary to an increase in the hypothalamic set point. 1, 3 The human body temperature rarely exceeds 41ºC. Normal circadian fluctuation in body temperature with increase in the evening and decrease in the morning continues even in febrile patients. 4 Under normal circumstances, core body temperature is tightly regulated, with a variation of approximately 0.5ºC. While it is uncertain as to the benefits of fever, there are suggestions that the increased body temperature aids in the activation of the host immune response with augmentation of bactericidal, phagocytic and chemotactic properties of polymorphonuclear leukocytes. The negative aspects of fever include increased basal metabolic rate and increased cardiac demand. FEVER: INTERACTION WITH PREGNANCYPhysiologic changes of pregnancy include an increase in the maternal basal metabolic rate. 5 Maternal body temperature in labor is also significantly affected by the degree of physical activity and intensity of uterine contractions. Pain associ- INTRODUCTION Fever is a common clinical problem in labor and delivery suites -worldwide. The febrile parturient presents a unique diagnostic dilemma and therapeutic challenge to both an obstetrician and an anesthesiologist involved in her care. Fever can result from a variety of infectious microorganisms, tissue trauma, malignancy, drug administration, endocrine and immunological disorders. However, infection is by far the most common cause of fever in the parturient. 1, 2 The infectious etiology of fever in a parturient may be pregnancy specific, such as chorioamnionitis, or not specific to pregnancy, such as urinary tract infection. The risk to the mother and the fetus is significantly increased in pregnancy complicated by infection and fever. The diverse clinical manifestations of various infectious disorders combined with the unique anesthetic implications of pregnancy may result in life-threatening complications and significantly impact upon the practice of obstetric anesthesia.The diagnosis of infection in pregnancy often raises questions about the safety of neuraxial anesthesia in febrile patients. Despite this concern, and lack of universal guidelines, it has now been well established that the presence of infection and fever in labor does not always contraindicate the administration of regional anesthesia. 2 The decision whether to administer regional anesthesia or not in a febrile parturient should be based on an individual risk-to-benefit ratio.

show abstract

“…It has been reported that PAS could be prevented by warming skin-surface [6] and warming the administered fluid [7,8], but it is not a perfect way. Many drugs have been shown to be effective on prevention of PAS, such as opioids, α2-agonist, anticholinergic, CNS stimulant, corticosteroid [9], however, few of them were recommended for the prevention of PAS due to various side-effects.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of ondansetron in preventing postanesthesia shivering: a meta-analysis of randomized controlled trials

Tie

et al. 2014

BMC Anesthesiol

View full text Add to dashboard Cite

BackgroundShivering is a very common complication in the postanesthesia period. Increasing studies have reported ondansetron may be effective in prevention of postanesthesia shivering (PAS). However, the results remained controversial; hence we conducted a meta-analysis of randomized controlled trials to evaluate the efficacy and safety of ondansetron on the prevention of postanesthesia shivering.MethodsPubMed and Embase databases were searched to identify the eligible randomized controlled trials assessing the effect of ondansetron on the prevention of PAS. Results were expressed as risk ratios (RRs) with accompanying 95% confidence intervals (CIs). The meta-analysis was performed with fixed-effect model or random-effect model according to the heterogeneity.ResultsSix trials including 533 subjects were included. Compared with placebo, ondansetron was associated with a significant reduction of PAS (RR 0.43, 95% CI, 0.27-0.70), without an increased risk of bradycardia (RR 0.37, 95% CI, 0.12-1.15). Compared with meperidine, no difference was observed in the incidence of PAS (RR 0.68, 95% CI, 0.39-1.19) and bradycardia (RR 2.0, 95% CI, 0.38-10.64).ConclusionsOndansetron has a preventive effect on PAS without a paralleled side effect of bradycardia.

show abstract

Anaesthetic temperature and shivering in epidural anaesthesia

Cited by 39 publications

References 15 publications

Temperature Monitoring and Perioperative Thermoregulation

Temperature Monitoring and Perioperative Thermoregulation

The febrile parturient: choice of anesthesia

Efficacy and safety of ondansetron in preventing postanesthesia shivering: a meta-analysis of randomized controlled trials

Contact Info

Product

Resources

About