Inadvertent Perioperative Hypothermia: A Literature Review of an Old Overlooked Problem

Fatemi, Seyed Naser Lotfi; Armat, Mohammad Reza; Zeydi, Amir Emami; Soleimani, Aria; Kiabi, Farshad Hasanzadeh

doi:10.1515/afmnai-2016-0001

Cited by 5 publications

(5 citation statements)

References 24 publications

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“…Contradictory to these results, in our study, a higher stage of shivering happened for the female; this may have happened because of the type of surgeries in this study. A few researchers have found that less use of opiates can cause more shivering, as well as we know that pain threshold is higher in women and indeed BIS monitor would show a less score for a woman suffering from a pain compare to a man in the same situation [7], [9]. It has been previously shown that patients who underwent anaesthesia with Pentothal experience a higher incidence of postoperative shivering compare to propofol [2], [22].…”

Section: Discussionmentioning

confidence: 99%

“…Nonetheless, they are less efficient than certain drugs such as tramadol, dexamethasone, pethidine, clonidine and physostigmine [6], [7], [8]. Pethidine is the most prevalent drug for managing postoperative shivering [9].…”

Section: Introductionmentioning

confidence: 99%

“…The exact mechanism of postoperative shivering is not well elucidated [11]. Although perioperative hypothermia has been considered as one of the possible mechanisms of postoperative shivering [7], [11], this has not been confirmed by more recent studies [12]. Recently, the depth of anaesthesia has been suggested as a probable risk factor for developing postoperative shivering [3], [13], [14].…”

Section: Introductionmentioning

confidence: 99%

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Association Between Bispectral Index (BIS) Value and Postoperative Shivering in Patients Undergoing Orthopedic Surgery

Moghadam¹,

Nematshahi²,

Dowlat-Abadi³

et al. 2019

Open Access Maced J Med Sci

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BACKGROUND: Postoperative shivering is one of the most common adverse effects after general anaesthesia. AIM: This study aimed to evaluate the association between the Bispectral index (BIS) monitoring value and postoperative shivering in patients undergoing orthopaedic surgery. MATERIAL AND METHODS: This cross-sectional study was conducted in Shahid Beheshti Hospital in Sabzevar city, from August 2017 to September 2018. Patients who underwent orthopaedic surgery, using general anaesthesia, were enrolled. Recording of the depth of anaesthesia using BIS monitoring was started exactly 5 minutes after intubating the patient and continued until the discharge from post-anesthesia care unit (PACU). The incidence of postoperative shivering was evaluated using a scale proposed by Crossley and Mahajan. RESULTS: A total number of 80 patients were evaluated. 32.5% of patients experience postoperative shivering grade 2, with mean BIS score 41.85. The univariate and multivariate linear regression analysis indicated a statistically significant relationship between shivering score and patients' heart rate, blood pressure, BIS score, temperature, age, height, gender and blood cell distribution width (RDW) (p < 0.05). CONCLUSION: The results of this study indicate a significant positive association between BIS value and postoperative shivering in patients undergoing orthopaedic surgery, so that, patients with higher BIS score experienced significantly more postoperative shivering. It seems that BIS-guided anaesthesia can reduce the risk and incidence of postoperative shivering in patients undergoing orthopaedic surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Association Between Bispectral Index (BIS) Value and Postoperative Shivering in Patients Undergoing Orthopedic Surgery

Moghadam¹,

Nematshahi²,

Dowlat-Abadi³

et al. 2019

Open Access Maced J Med Sci

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“…On the other hand, the use of cold liquids exacerbates hypothermia ( 5 , 6 ). Persistent hypothermia can lead to complications such as postoperative shivering, coagulopathy, decreased immunity, cardiac morbidity ( 7 ), postsurgical wound infection, impaired wound healing, prolonged recovery from anesthesia and prolonged hospital stay ( 6 , 8 , 9 ).…”

Section: Introductionmentioning

confidence: 99%

Comparison of Intravenous Ketamine with Intrathecal Meperidine in Prevention of Post-anesthetic Shivering after Spinal Anesthesia for Lower Limb Orthopedic Surgeries: A Double-blind Randomized Clinical Trial

Gholinataj

Baradari

Najafi

et al. 2021

Ethiop J Health Sci

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BACKGROUND፡ Post-anesthetic shivering is one of the most common complications after anesthesia. Ketamine has been considered to be an effective treatment for post-anesthetic shivering, but the evidence for its therapeutic benefit after spinal anesthesia is limited. The aim of this study was to compare the effects of intravenous ketamine with intrathecal meperidine in the prevention of post-anesthetic shivering after spinal anesthesia for lower limb orthopedic surgeries.METHODS: In a double-blind randomized parallel-group clinical trial, a total of 150 patients scheduled for lower limb orthopedic surgeries under spinal anesthesia were selected and randomly divided into three equally sized groups of intravenous ketamine (0.5mg/kg), intrathecal meperidine (0.2mg/kg) or intravenous normal saline (as placebo). The intensity of shivering in patients were evaluated during surgery and after transfer into the post anesthesia care unit. Also, changes in patients' drowsiness, nausea, vomiting, pruritus, mean arterial pressure, heart rate, and arterial oxygen saturation (SPO2) during surgery and until the end of anesthesia were evaluated.RESULTS: In all times of evaluation (20, 60, 80, 100 and 120 minutes after onset of spinal anesthesia) patients in control group showed a greater intensity of shivering compared to other groups. However, patients who received intrathecal meperidine experienced significantly lower intensity of post anesthetic shivering (p<0.05). The results showed a significant mean arterial pressure and heart rates differences between the three groups, only on 20 and 60 minutes after initiation of spinal anesthesia. The incidence of nausea, vomiting, and pruritus was not significantly different in all three groups, although all patients who received ketamine experienced drowsiness after surgery (p<0.001).CONCLUSION: The results of the present study showed that, although both intrathecal meperidine and intravenous ketamine could effectively prevent postoperative shivering after spinal anesthesia in lower limb orthopedic surgeries, intrathecal meperidine was associated with more efficacy benefits and a lower frequency of side effects such as post-anesthesia drowsiness.

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“…Patients undergoing free-flap microvascular surgery are particularly susceptible to IPH complications such as complete flap failure, surgical site infection, delayed wound healing, coagulopathies, dysrhythmias, myocardial events, and even death. [5][6][7][8] A comprehensive clinical review by Berrios-Torres et al 9 did not identify any randomized controlled trials that evaluated strategies to prevent surgical site infection associated with IPH but did call upon observational evidence suggesting that active warming measures may be effective in preventing surgical site infection. In both retrospective studies and randomized controlled trials, actively warmed patients experienced less blood loss and of care to meet national quality improvement goals to reduce perioperative complications and improve postoperative outcomes.…”

mentioning

confidence: 99%

Warming bundle for patients with microvascular free-flaps

Diaz,

Duclos,

Mifsud

et al. 2023

Nursing

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Inadvertent Perioperative Hypothermia: A Literature Review of an Old Overlooked Problem

Cited by 5 publications

References 24 publications

Association Between Bispectral Index (BIS) Value and Postoperative Shivering in Patients Undergoing Orthopedic Surgery

Association Between Bispectral Index (BIS) Value and Postoperative Shivering in Patients Undergoing Orthopedic Surgery

Comparison of Intravenous Ketamine with Intrathecal Meperidine in Prevention of Post-anesthetic Shivering after Spinal Anesthesia for Lower Limb Orthopedic Surgeries: A Double-blind Randomized Clinical Trial

Warming bundle for patients with microvascular free-flaps

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