Incidence of shivering after cesarean section under spinal anesthesia with or without intrathecal sufentanil: a randomized study. Effect of preoperative warming during cesarean section under spinal anesthesia Intraoperative forced air-warming during cesarean delivery under spinal anesthesia does not prevent maternal hypothermia. Intrathecal Meperidine Plus Lidocaine for Prevention of Shivering during Cesarean Section Intrathecal Meperidine Decreases Shivering During Cesarean Delivery Under Spinal Anesthesia Intrathecal fentanyl for prevention of shivering in spinal anesthesia in cesarean section Effect of low dose of intrathecal pethidine on the incidence and intensity of shivering during cesarean section under spinal anesthesia: a randomized, placebo-controlled, double-blind clinical trial The effect of pre-warmed intravenous fluids on prevention of intraoperative hypothermia in cesarean section Effects of intrathecal dexmedetomidine on shivering after spinal anesthesia for cesarean section: a double-blind randomized clinical trial Intrathecal injection of magnesium sulfate: shivering prevention during cesarean section: a randomized, double-blinded, controlled study Intrathecal fentanyl for prevention of shivering in cesarean section. Lower Limb Wrapping Prevents Hypotension, but Not Hypothermia or Shivering, After the Introduction of Epidural Anesthesia for Cesarean Delivery Intrathecal Dexmedetomidine Alleviates Shivering during Cesarean Delivery under Spinal Anesthesia. Preoperative Warming Versus no Preoperative Warming for Maintenance of Normothermia in Women Receiving Intrathecal Morphine for Cesarean Delivery: A Single-Blinded, Randomized Controlled Trial Active Warming During Cesarean Delivery [Efficacy of a novel warming blanket: prospective randomized trial]. Warming with an underbody warming system reduces intraoperative hypothermia in patients undergoing laparoscopic gastrointestinal surgery: a randomized controlled study.
BACKGROUND AND OBJECTIVES Shivering is a cause of discomfort and dissatisfaction in patients undergoing cesarean section . The objective of this study paper was to assess the impact of intrathecal administration of sufentanil on the incidence of shivering after cesarean section . METHOD In a prospect i ve blinded , r and omized clinical trial , pregnant women undergoing cesarean section under spinal anesthesia were enrolled . Pregnant women in labor , febrile , obese , with pregnancy-induced hypertension , anesthetic block failure or surgical complications were excluded . Patients were r and omly assigned to two groups . In Group I , 10 mg of 0.5 % hyperbaric bupivacaine combined with 80 mcg of morphine and 2.5 mcg of sufentanil were administered . In Group II , 10 mg of 0.5 % hyperbaric bupivacaine combined with 80 mcg of morphine were administered . In the post-anesthesia care unit , patients were evaluated for signs of shivering by an investigator blinded to the patient 's group allocation . RESULTS The sample consisted of 80 patients . In both groups there was a decrease in axillary temperature of patients after cesarean section ( p<0.001 ) . This decrease was not different between groups ( p<0.21 ) . In Group I , the incidence of tremor was 32.5 % ( 13/40 ) and in Group II it was 62.5 % ( 25/40 ) ( p<0.007 ) ; RR 0.53 ( CI 95 % 0.32 - 0.87 ) . CONCLUSIONS It has been suggested that the addition of sufentanil to hyperbaric bupivacaine and morphine during spinal anesthesia for cesarean section provides a decrease in the incidence of shivering in the immediate postoperative period Background Postoperative hypothermia and shivering is a frequent event in patients during cesarean section under spinal anesthesia . We assessed the effect of preoperative warming during cesarean delivery under spinal anesthesia for prevention of hypothermia and shivering . Methods Forty five patients undergoing elective cesarean section were r and omly assigned to three groups . Group F received warmed intravenous fluid ( 40 ℃ ) . Group A patients were actively warmed by forced air-warming . Group C was the control group . Forced air-warming and warmed fluid was maintained for the 15 min preceding spinal anesthesia  . Core temperature ( tympanic membrane ) and the skin temperature of arm and thigh were measured and shivering was grade d simultaneously . Results The core temperature at 45 min decreased less in Groups F and A than Group C ( -0.5 ℃ ± 0.3 ℃ vs -0.6 ℃ ± 0.4 ℃ vs -0.9 ℃ ± 0.4 ℃ , respectively ; P = 0.004 ) . The arm temperature at 15 min and 30 min exhibited a greater increase in Group A than Group F and Group C ( P = 0.001 and P = 0.012 , respectively ) . Leg temperature increased similarly among the three groups . The incidence of shivering was significantly less in Group A and Group F than Group C ( 20 % , 13.3 % , and 53.3 % , respectively ; P = 0.035 ) . Conclusions Preoperative forced air-warming and warmed fluid prevents hypothermia and shivering in patients undergoing elective cesarean delivery with spinal anesthesia BACKGROUND Prewarming and intraoperative warming with forced air-warming systems prevent perioperative hypothermia and shivering in patients undergoing elective cesarean delivery with epidural anesthesia . We tested the hypothesis that intraoperative lower body forced air-warming prevents hypothermia in patients undergoing elective cesarean delivery with spinal anesthesia . METHODS Thirty healthy patients undergoing cesarean delivery with spinal anesthesia were r and omly assigned to forced air-warming or control groups ( identical cover applied with forced air-warming unit switched off ) . A blinded investigator assessed oral temperature , shivering , and thermal comfort scores at 15-min intervals until discharge from the postanesthetic care unit . Umbilical cord blood gases and Apgar scores were also measured after delivery . RESULTS The maximum core temperature changes were similar in the two groups ( -1.3 degrees C + /- 0.4 degrees C vs -1.3 degrees C + /- 0.3 degrees C for the forced air-warming group and control group , respectively ; P = 0.8 ) . Core hypothermia ( < or = 35.5 degrees C ) occurred in 8 of 15 patients receiving forced air-warming and in 10 of 15 unwarmed patients ( P = 0.5 ) . The incidence and severity of shivering did not significantly differ between groups . Umbilical cord blood gases and Apgar scores were similar in both groups ( P = NS ) . CONCLUSIONS We conclude that intraoperative lower body forced air-warming does not prevent intraoperative hypothermia or shivering in women undergoing elective cesarean delivery with spinal anesthesia 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 prospect i ve r and omized , 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 r and omly 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 Shivering associated with spinal anesthesia is uncomfortable and may interfere with monitoring . We performed this prospect i ve , double-blinded , and r and omized study to determine whether intrathecal meperidine ( 0.2 mg/kg ) decreases the incidence and intensity of shivering after spinal anesthesia for cesarean delivery . Forty parturients scheduled for nonemergent cesarean delivery were enrolled in two groups .  Spinal anesthesia consisted of hyperbaric bupivacaine ( 0.75 % ; 10.5 mg ) , morphine 0.15 mg , and , in the experimental group , meperidine ( 0.2 mg/kg ) or , in the control group , normal saline . Data collection , including sensory block level , blood pressure , core temperature , and shivering intensity , was performed every minute for 10 min , every 3 min for 33 min , and then every 5 min until the sensory level receded to L4 . Time to highest sensory level , maximum number of blocked segments , sensory and motor blockade regression , and systolic blood pressure showed no difference between groups . The incidence of shivering was less ( P < 0.02 ) in the meperidine group , as was its intensity ( P < 0.003 ) . Intrathecal meperidine ( 0.2 mg/kg ) is effective in reducing the incidence and intensity of shivering associated with spinal anesthesia for cesarean delivery Background Shivering is one of the common problems in spinal anesthesia . The objective of the present study was to evaluate the effect of intrathecal fentanyl ( 25 µg ) on incidence and severity of intraoperative and postoperative shivering . Methods A double-blind r and omized controlled study was conducted in eighty healthy women ( ASA Physical status I ) scheduled for elective cesarean section under spinal anesthesia . Subjects were r and omly divided into two equal groups . The patients received 12.5 mg ( 2.5ml ) of 0.5 % hyperbaric bupivacaine combined with 25 µg ( 0.5 ml ) fentanyl in Group F as a study group and 12.5 mg ( 2.5ml ) of 0.5 % hyperbaric bupivacaine combined with 0.5 ml normal saline in Group S as a control group . Incidence of shivering during 30 and 60 minutes of surgery and recovery and complications were evaluated . Results The total incidence of shivering in Group F was significantly lower than Group S ( 10 % in group F ; 75 % in group S , p < 0.0001 ) . Almost all patients started shivering in the first hour after spinal anesthesia and the rate of shivering especially in second 30 minutes was higher than first 30 minutes in both groups . None in Group F but 22 patients ( 55 % ) in Group S had shivering during recovery and all of them reported shivering at the first 30 minute at recovery . The severity of shivering in Group F was significantly lower than Group S ( p < 0.0001 ) . Conclusion Intrathecal bupivacaine combined with fentanyl is associated with a lower incidence and severity of shivering Introduction Shivering is among the unpleasant and potentially harmful side effects of spinal anesthesia . The aim of this r and omized double-blind clinical trial was to compare the antishivering effect of two different doses of intrathecal pethidine on the incidence and intensity of shivering and other side effects in patients who underwent cesarean section . Methods In this study , 150 parturient females scheduled for nonemergent cesarean section were r and omly allocated to three groups . Spinal anesthesia was performed with 0.5 % hyperbaric bupivacaine ( 12.5 mg ) , plus 0.5 mL of 0.9 % saline in the st and ard group ( S group ) , and the same dose of bupivacaine with 5 mg ( P5 group ) or 10 mg of pethidine ( P10 group ) . Demographic and surgical data , incidence and intensity of shivering ( primary outcome ) , hemodynamic indices , forehead and core temperatures , maximum sensory level , Apgar scores , and adverse events were evaluated by a blinded observer . Results There were no significant differences between the three study groups regarding the demographic and surgical data , hemodynamic indices , core temperatures , and maximum sensory level ( P>0.05 ) . The incidence and intensity of shivering were significantly less in the P5 and P10 groups ( P<0.001 ) when compared with the S group . There were no significant differences between groups for secondary outcomes , except pruritus , which was more common in the P5 and P10 groups when compared with the S group ( P=0.01 ) . Conclusion Low dose of intrathecal pethidine is safe , and can decrease the incidence and intensity of shivering during cesarean section , without having major side effects Background : Hypothermia is one of the problems occurring during surgery , which can happen due to thermoregulation mechanism disorders and intake of low temperature IV fluids , and may cause increase in blood pressure , heart rate , intracranial pressure , oxygen consumption , pain , and discomfort to the patient . The rate of cesarean section in our country is three times more than the global st and ard . As one of the responsibilities of the nurse is patient 's advocacy , s/he should support them . This study aim ed to investigate the effect of pre-warmed intravenous fluids on prevention of hypothermia during general anesthesia in cesarean section . Material s and Methods : Sixty-two women undergoing elective cesarean section by general anesthesia were r and omly allocated in two groups of intervention and control . Women in the intervention group received pre-warmed serum ( 37 ° C ) while those in the control group received serum at room temperature ( 25.5 ° C ) . The core body temperature and some hemodynamic parameters of the participants were assessed during the operation . Results : The mean of pulse rate , systolic blood pressure , diastolic blood pressure , and arterial O2 saturation in the two groups were not statistically significant ( P > 0.05 ) . But the mean of mothers ’ core body temperature at the end of anesthesia in the intervention and control groups were 36 ± 0.5 ° C and 35.34 ± 0.6 ° C , respectively ( P < 0.05 ) . Conclusion : Infusion of pre-warmed serum ( 37 ° C ) would prevent intraoperative hypothermia and improve the nursing care for women who undergo cesarean section by general anesthesia Background Shivering is among the common troublesome complications of spinal anesthesia ( SA ) , and causes discomfort and discontentment in parturients undergoing cesarean sections ( CSs ) . The aim of this study was to investigate the effects of intrathecal dexmedetomidine in the prevention of shivering in those who underwent CS under SA . Subjects and methods Fifty parturients planned for elective CSs under SA were enrolled in this prospect i ve , double-blinded , controlled study and r and omly divided into two equal groups . Spinal block was achieved with 12.5 mg 0.5 % heavy bupivacaine plus 5 μg dexmedetomidine ( BD group ) or 0.5 mL 0.9 % normal saline ( BN group ) . The incidence and intensity of shivering , peripheral and core body temperature , hemodynamic parameters , and adverse events was recorded . Results The incidence of shivering was significantly higher in the BN group ( 52 % ) than the BD group ( 24 % ) ( P=0.04 ) . Likewise , the intensity of shivering was significantly higher in the BN group than the BD group ( P=0.04 ) . The incidence of adverse events , such as hypotension , nausea/vomiting , and bradycardia , was not significantly different between the two groups , although the grade of sedation was higher in the BD group than the BN group ( P=0.004 ) . Conclusion We conclude that intrathecal dexmedetomidine is effective in lowering the incidence and intensity of shivering in parturients undergoing CSs under SA without major adverse effects Background Regional anesthesia is known to significantly impair thermoregulation and predispose patients to hypothermia . We hypothesized that the addition of an intrathecal injection of magnesium sulfate ( MgSO4 ) to bupivacaine would improve perioperative shivering in female patients undergoing elective caesarean section . Methods In a block-r and omized , double-blinded , controlled trial 72 patients scheduled for elective caesarean section with spinal anesthesia were separated into two groups . In the treatment group , 2 ml of 0.5 % bupivacaine plus 25 mg MgSO4 ( 0.5 ml ) were injected intrathecally , and in the control group 2 ml of 0.5 % bupivacaine plus 0.5 ml normal saline were injected intrathecally . Core temperature was measured before and after drug injection at predetermined intervals . Sedation was grade d using the Ramsay sedation scale . Results No significant intergroup differences in appearance of shivering were seen immediately or at 5 , 30 , 40 , 50 , 60 , and 90 min after block administration . However , at 10 , 15 , and 20 min post block , there was a significant difference in shivering . The group administered MgSO4 showed lower shivering grade s compared with the control group . Core temperature was significantly reduced in the MgSO4 group compared to the normal saline group 30 min after blocking . Conclusions Intrathecal injection of MgSO4 improved perioperative shivering in female patients undergoing elective caesarean section OBJECTIVES The aim of this r and omized double-blind study was to investigate whether 20 microg of intrathecally administered fentanyl would influence the incidence and severity of shivering in patients undergoing cesarean section . MATERIAL AND METHOD Sixty healthy patients scheduled for cesarean section under spinal anesthesia using 2.2 ml of 0.5 % hyperbaric bupivacaine with 0.2 ml of morphine 0.2 mg , were r and omly allocated to receive an additional 0.4 ml of fentanyl 20 mg intrathecally ( Group F ) or normal saline 0.4 ml ( Group S ) . RESULTS The incidence of shivering three hours after spinal anesthesia was 6 of 30 patients , 20 % in Group F and 15 of 30 patients , 50 % in Group S. The difference was statistically significant ( p < 0.05 ) . Almost all of the shivering patients started in their first hour after spinal anesthesia ( 5 patients in Group F and 13 patients in Group S ) . None in Group F but 4 patients in Group S started shivering before their babies were delivered . The shivering score was also significantly lower in Group F ( p < 0.05 ) . Treatment for shivering was requested in 16 % and 26 % of the shivering patients in Group F and Group S , respectively . There was no difference in the incidence of pharmacologic side effects . The core temperature did not differ significantly between the groups during 3 hours after spinal anesthesia . CONCLUSION The addition of 20 microg fentanyl in 2.2 ml of 0.5 % hyperbaric bupivacaine with 0.2 ml of morphine 0.2 mg intrathecally can reduce the incidence and severity of intraoperative and postoperative shivering after spinal anesthesia for patients who were receiving cesarean section without increasing other side effects The decrease of arterial blood pressure and body temperature after epidural or spinal anesthesia is thought to be the result of sympathetic block , which could cause pooling and redistribution of blood into the lower extremities . Studies have demonstrated that leg wrapping with elastic b and ages may reduce the incidence of hypotension after spinal anesthesia . We tried to extend these previous observations to epidural anesthesia by testing the hypothesis that leg wrapping with elastic b and ages should decrease the incidence of hypotension in patients receiving epidural anesthesia . Moreover , we evaluated the effect of this maneuver as regards hypothermia and shivering .  Sixty parturients were r and omly allocated to receive either leg wrapping with tight elastic b and ages ( leg-wrapped group ) or not ( control group ) before anesthesia . Sublingual temperature was observed at five periods : baseline , immediately after epidural anesthesia , abdominal skin disinfection , skin incision , and delivery . Hypotension and shivering during the observation periods were also recorded . The incidence of hypotension was significantly less frequent ( P = 0.03 ) in the leg-wrapped group ( 23 % ) compared with the control group ( 50 % ) . Shivering incidences were similar in both groups ( 70 % versus 70 % ) . Sublingual temperature decreased significantly ( P < 0.001 ) throughout the procedure in each group . However , no differences were found between the two groups at each design ated observation , even if compared by the magnitude of temperature decrease . We conclude that although leg wrapping with elastic b and ages prevents maternal hypotension after epidural anesthesia , it does not reduce the incidence or magnitude of hypothermia or prevent shivering Shivering associated with spinal anesthesia during Cesarean delivery is an uncomfortable experience for the parturient , which may also cause adverse effects . In this prospect i ve , r and omized , double-blind , placebo-controlled study , we sought to evaluate the effect of intrathecal dexmedetomidine , administered as an adjunct to hyperbaric bupivacaine for Cesarean delivery , on the incidence and severity of shivering associated with spinal anesthesia . Patients undergoing Cesarean delivery were r and omly allocated to three groups of 30 patients each . Experimental treatments were added to hyperbaric bupivacaine as follows : Patients in group I ( control ) were administered isotonic saline . Patients in groups II and III received dexmedetomidine ( 2.5 , 5 µg , respectively ) , mixed with isotonic saline . Shivering was observed in 11 , 10 and 2 patients in groups I , II and III , respectively . The incidence of shivering in group III was significantly lower than that in groups I ( p=0.005 ) and II ( p=0.01 ) . The severity of shivering was significantly different between the three groups ( p=0.01 ) . There were no significant inter-group differences with respect to mean arterial pressure and heart rate at any time point after administration of intrathecal local anesthesia ( p>0.05 ) . Intrathecal dexmedetomidine ( 5 µg ) administered as an adjunct to hyperbaric bupivacaine during Cesarean delivery significantly reduced the incidence and intensity of shivering associated with spinal anesthesia BACKGROUND : Rates of hypothermia for women undergoing spinal anesthesia for cesarean delivery are high and prevention is desirable . This trial compared the effectiveness of preoperative warming versus usual care among women receiving intrathecal morphine , which is thought to exacerbate perioperative heat loss . METHODS : A prospect i ve , single-blinded , r and omized controlled trial compared 20 minutes of forced air warming ( plus intravenous fluid warming ) versus no active preoperative warming ( plus intravenous fluid warming ) in 50 healthy American Society of Anesthesiologists grade d II women receiving intrathecal morphine as part of spinal anesthesia for elective cesarean delivery . The primary outcome of maternal temperature change was assessed via aural canal and bladder temperature measurements at regular intervals . Secondary outcomes included maternal thermal comfort , shivering , mean arterial pressure , agreement between aural temperature , and neonatal outcomes ( axillary temperature at birth , Apgar scores , breastfeeding , and skin-to-skin contact ) . The intention-to-treat population was analyzed with descriptive statistics , general linear model analysis , linear mixed-model analysis , & khgr;2 test of independence , Mann-Whitney , and Bl and -Altman analysis . Full ethical approval was obtained , and the study was registered on the Australia and New Zeal and Clinical Trials Registry ( Trial No : 367160 , registered at http://www.ANZCTR.org.au/ ) . RESULTS : Intention-to-treat analysis ( n = 50 ) revealed no significant difference in aural temperature change from baseline to the end of the procedure between groups : F ( 1 , 47 ) = 1.2 , P = .28 . There were no other statistically significant differences between groups in any of the secondary outcomes . CONCLUSIONS : A short period of preoperative warming is not effective in preventing intraoperative temperature decline for women receiving intrathecal morphine . A combination of preoperative and intraoperative warming modalities may be required for this population We tested the hypothesis that 15 min of forced-air prewarming , combined with intraoperative warming , prevents hypothermia and shivering in patients undergoing elective cesarean delivery . We simultaneously tested the hypothesis that maintaining maternal normothermia increases newborn temperature , umbilical vein pH , and Apgar scores .  Thirty patients undergoing elective cesarean delivery were r and omly assigned to forced-air warming or to passive insulation . Warming started 15 min before the induction of epidural anesthesia . Core temperature was measured at the tympanic membrane , and shivering was grade d by visual inspection . Patients evaluated their thermal sensation with visual analog scales . Rectal temperature and umbilical pH were measured in the infants after birth . Results were compared with unpaired , two-tailed Student ’s t-tests and & khgr;2 tests . Core temperatures after 2 h of anesthesia were greater in the actively warmed ( 37.1 ° C ± 0.4 ° C ) than in the unwarmed ( 36.0 ° C ± 0.5 ° C;P < 0.01 ) patients . Shivering was observed in 2 of 15 warmed and 9 of 15 unwarmed mothers ( P < 0.05 ) . Babies of warmed mothers had significantly greater core temperatures ( 37.1 ° C ± 0.5 ° C vs 36.2 ° C ± 0.6 ° C ) and umbilical vein pH ( 7.32 ± 0.07 vs 7.24 ± 0.07 ) BACKGROUND Perioperative hypothermia is a common complication of general anesthesia and occurs in up to 50 % of patients during ear , nose and throat ( ENT ) surgery . In this prospect i ve , r and omized controlled study the hypothesis that a new conductive warming blanket ( Barrier ® EasyWarm ® , Mölnlycke Health Care Erkrath , Germany ) is better in reducing the incidence of perioperative hypothermia in ENT surgery than insulation with a conventional hospital duvet alone was tested . MATERIAL S AND METHODS After approval of the local ethics committee and written informed consent 80 patients with a planned procedure time between 1 and 3 h were recruited .  Anesthesia was induced and maintained using propofol , remifentanil and rocuronium and the core temperature was measured using an esophageal temperature probe . Patients in the study group were warmed at least 30 min prior to induction of anesthesia using the novel warming blanket ( Barrier ® EasyWarm ® ) and patients in the control group were insulated with a st and ard hospital duvet . Data were tested using Fisher 's exact test , Student 's t-test or the Mann-Whitney U-test as appropriate . Time-dependent changes in core temperature were evaluated using repeated measures analysis of variance ( ANOVA ) and post hoc Scheffé 's test . Results are expressed as mean ± SD or as median and interquartile range ( IQR ) as appropriate . A p < 0.05 was considered to be statistically significant . RESULTS The ANOVA did not identify a significantly higher core temperature in the study group at any time point . Furthermore , Fisher 's exact test showed no differences in the incidence of intraoperative ( 12 out of 29 versus 10 out of 32 patients , p = 0.44 ) or postoperative hypothermia ( 12 out of 29 versus 9 out of 32 patients , p = 0.30 ) between the groups . No adverse effects were observed . CONCLUSIONS In the studied patient group the new conductive warming blanket ( Barrier ® EasyWarm ® ) showed no superiority compared to conventional thermal insulation alone BACKGROUND Intraoperative hypothermia is a common event during laparoscopic abdominal surgery . On one h and , intraoperative hypothermia can delay the metabolism and prevent tissue damage . One the other h and , long-term and severe intraoperative hypothermia may also lead to perioperative complications , such as increasing of peripheral resistance , coagulation dysfunction , intraoperative hemorrhage and postoperative shivering . Maintenance of normothermia during surgical procedures may improve the quality of patient care . OBJECTIVES This study investigated the feasibility and efficacy of intraoperative cutaneous warming with an underbody warming system during laparoscopic gastrointestinal surgery . METHODS 110 patients undergoing laparoscopic surgery for gastrointestinal cancer between January and December 2011 were r and omized into the laparoscopic control ( Control ) group and laparoscopic intervention ( Intervention ) group . Nasopharyngeal temperature , prothrombin time , activated partial thromboplastin time , and thrombin time were measured before and during surgery , intraoperative and postoperative complications , as well as shivering after anesthesia and visual analog scale score for pain evaluation after surgery were also recorded . Clinical risk factors that may cause intraoperative hypothermia during laparoscopic surgery were also analyzed by correlation analysis . RESULTS The two groups were comparable at the baseline . Intraoperative hypothermia was observed in 29 patients ( 52.7 % ) in Control group and 3 ( 5.5 % ) in Intervention group . Nasopharyngeal temperature in Control group was significantly decreased since 30min after the start of operation until the end of surgery comparing to that at the start of anesthesia , but there was no difference in the Intervention group . In Intervention group , the nasopharyngeal temperature was remaining at ∼36.5 ° C , indicating the feasibility and efficiency of the underbody warming system in preventing intraoperative hypothermia during laparoscopic gastrointestinal surgery . Moreover , with anesthesia and operation time increased , there was no significant change of coagulation function , hemoglobin level as well as less intraoperative hemorrhage , less postoperative shivering and lower visual analog scale score in Intervention group comparing to Control group . Multivariate logistic regression analysis revealed that anesthesia time and volume of CO2 were independent risk factors for perioperative hypothermia . CONCLUSIONS Cutaneous warming with an underbody warming system is a feasible and effective method to prevent intraoperative hypothermia during laparoscopic gastrointestinal surgery
The results showed that , compared with placebo , pethidine , fentanyl , dexmedetomidine , and sufentanil significantly reduced the incidence of perioperative shivering .
In addition , compared with sufentanil , fentanyl showed no impact on haemodynamic stability and the incidence of pruritus .
CONCLUSION Pethidine , fentanyl , dexmedetomidine , and sufentanil appear to be effective for preventing perioperative shivering in puerperae undergoing cesarean sections .
Considering the risk-benefit profiles of the included neuraxial adjuvants , fentanyl is probably the optimal choice
BACKGROUND Perioperative shivering is clinical ly common during cesarean sections under neuraxial anesthesia , and several neuraxial adjuvants are reported to have preventive effects on it .
However , the results of current studies are controversial and the effects of these neuraxial adjuvants remain unclear .
AIM To evaluate the effects of neuraxial adjuvants on perioperative shivering during cesarean sections , thus providing an optimal choice for clinical application .