Prophylaxis of shivering in the perioperative period of spinal anesthesia

Abstract

Shivering and hypothermia caused by redistribution of core body heat and impaired thermoregulation system by tonic vasodilation, leads to morbidity and mortality in high risk patients. Perioperative shivering is a common problem in anesthesia practice. If it is not properly managed and prevented, it causes discomfort and devastating problems, especially in patients with cardiorespiratory problems. Surgery, anesthesia, exposure of the skin in a cool operating theatre, and administration of not heated fluids are some of the major causes for the development of shivering among surgical patients. Currently, a variety of non-medicamental and pharmacological techniques are available to prevent and manage this problem. The available options to prevent and treat shivering include, but are not limited, pre-heating of the patient for 15 minutes before anesthesia, administration of low dose ketamine, dexamethasone, pethidine, clonidine, dexmedetomidine, tramadol, and magnesium sulfate.