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. Anesthesiology Consultant Anaesthetist
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 Consultant Anaesthetist
patients recovering from desflurane or isoflurane Alexandra Hospital
anesthesia. Anesthesiology 1998;89:878–888.
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
The Royal College of Anaesthetists
The material from this article may be copied for the purpose of producing information materials forpatients. Please quote the RCoA as the source of the information. If you wish to use part of thearticle in another publication, suitable acknowledgement must be given and the RCoA logo must beremoved. For more detailed enquiries about the use of this leaflet please contact: The Royal College of Anaesthetists
email: [email protected]
This leaflet will be reviewed three years from the date of publication.
2 Risks associated with your anaesthetic ❖ Information for Patients: The Royal College of Anaesthetists


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