International Journal of General Medicine (Sep 2022)

Evidence-Based Guideline on Prevention and Management of Shivering After Spinal Anesthesia in Resource-Limited Settings: Review Article

  • Amsalu H,
  • Zemedkun A,
  • Regasa T,
  • Adamu Y

Journal volume & issue
Vol. Volume 15
pp. 6985 – 6998

Abstract

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Hunde Amsalu,1 Abebayehu Zemedkun,2 Teshome Regasa,2 Yayeh Adamu2 1Department of Anesthesia, Wachemo University, Hosaena, Ethiopia; 2Department of Anesthesiology, Dilla University, Dilla, EthiopiaCorrespondence: Abebayehu Zemedkun, Department of Anesthesiology, Dilla University, Dilla, Ethiopia, Tel +251 900053426, Email [email protected]: Perioperative shivering is a common problem faced in anesthesia practice. Unless it is properly managed and prevented, it causes discomfort and devastating problems, especially in patients with cardiorespiratory problems. Surgery, anesthesia, exposure of skin in a cool operating theater, and administration of unwarmed fluids are some of the major causes for the development of shivering among surgical patients. Currently, a variety of non-pharmacological and pharmacological techniques are available to prevent and manage this problem. The available options to prevent and treat shivering include but are not limited to pre-warming the patient for 15 minutes before anesthesia administration, administration of low dose ketamine, dexamethasone, pethidine, clonidine, dexmedetomidine, tramadol, and magnesium sulfate.Objective: To develop evidence-based recommendations for the prevention and management of shivering after spinal anesthesia in a resource-limited settings.Methods: The kinds of literature are searched from Google Scholar, PubMed, Cochrane library, and HINARI databases to get access to current and update evidence on the prevention and management of shivering after spinal anesthesia. The keywords for the literature search were (shivering or prevention) AND (shivering or management) AND (anesthesia or shivering).Conclusion: Pre-warming the patient with cotton, blanket, gown warming, and administering warm IV fluid 15 minutes before spinal anesthesia are possible non-pharmacologic options for the prevention of shivering. Furthermore, pharmacological medications like low dose ketamine, dexamethasone, magnesium sulfate, ad tramadol can be used as alternative options for the prevention and management strategies for shivering of different degrees in resource-limited areas.Keywords: thermoregulation, shivering, perioperative, spinal anesthesia

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