Section 3: Shivering
A t the end of your operation, you will be taken to the recovery room. Recovery room staff will be with you at all times and will continue to monitor your blood pressure, oxygen levels and pulse rate. Some people shiver during this period. This article gives you information about shivering after an anaesthetic and how it can be treated. What is done to prevent it?
Although it can be extremely distressing,
anaesthetic you are having. This mayinclude:
‘It was incredibly frightening. I felt so
cold, and I didn’t know what to do orhow to stop it. I thought something
warming any intra-venous fluids orblood that you may receive.
Shivering is an involuntary process, whichmay affect various different parts of your
How often does shivering happen?
anaesthetic and during or after a regional
approximately 1 in 4 patients following ageneral anaesthetic.4 The risk of shivering
What causes it?
Most shivering after an operation is due to
used to keep you asleep during youranaesthetic contribute to this fall by
What can be done if shivering
reducing your body’s natural ability to
Shivering may also occur without a fall in
core body temperature. This is called non
There are also a number of drugs which can
thermoregulatory shivering. It can be due
be used to treat shivering, although it is
usually considered best to wait until the
1 Risks associated with your anaesthetic ❖ Information for Patients: The Royal College of Anaesthetists
include pethidine, tramadol and magnesium
sulphate.6 If you are in pain following your
reassure you about the shivering and also
operation, treatment of your pain may also
although distressing, it is generally not
dangerous. It does, however, increase your
body’s requirement for oxygen so you may
be given additional oxygen via a mask. Dr James E Bromilow, MRCP, FRCA
Macario A et al. Which clinical anesthesia
Specialist Registrar in Anaesthetics
outcomes are important to avoid? The perspective
Wessex School of Anaesthesia
of patients. Anesth Analg 1999;89:652–658.
de Witte J, Sessler DI. Perioperative shivering. Dr Lucy A White, MA, MRCP, FRCA
Physiology and pharmacology. AnesthesiologyConsultant Anaesthetist
2002;96:467–484. Southampton University Hospital Trust
Horn EP et al. Postoperative pain facilitates nonthermoregulatory tremor. Anesthesiology
1999;91(4):979–984. Dr Timothy C Smith, MD, FRCA
Horn EP et al. Non thermoregulatory shivering in
patients recovering from desflurane or isoflurane
anesthesia. Anesthesiology 1998;89:878–888. Redditch
Sessler DI, Ponte J. Shivering during epidural
Primary FRCA Examiner
anesthesia. Anesthesiology 1990;72:816–882.
Alfonsi P. Post anaesthetic shivering. Epidemiology, pathophysiology and approaches to prevention and management. Drugs 2001;61:2193–2205. The Royal College of Anaesthetists
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2 Risks associated with your anaesthetic ❖ Information for Patients: The Royal College of Anaesthetists
Glycemic Control With Diet, Sulfonylurea, Metformin, or Insulin in Patients With Type 2 Diabetes Mellitus: Progressive Requirement for Multiple Therapies (UKPDS Robert C. Turner; Carole A. Cull; Valeria Frighi; et al. JAMA . 1999;281(21):2005-2012 (doi:10.1001/jama.281.21.2005) Glycemic Control With Diet, Sulfonylurea, Metformin, or Insulin in Patients With Type 2 Diabetes Mellitus Progr
Blackwell Science, LtdOxford, UKBJUBJU International1464-4096BJU InternationalJune 2004939COMBINED THERAPY FOR ADVANCED PROSTATE CANCERL. KLOTZ et al. Combined androgen blockade is a A re-assessment of the role of controversial topic, which has arguments both for and against. It combined androgen blockade for is revisited by the authors of this advanced prostate cancer