Ferede Yonas Admasu, Aytolign Habtu Adane, Mersha Abraham Tarekegn
Department of Anesthesia, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Ann Med Surg (Lond). 2021 Nov 9;72:103022. doi: 10.1016/j.amsu.2021.103022. eCollection 2021 Dec.
Shivering is an involuntary, spontaneous, and repetitive contraction of the skeletal muscle and increases patients' discomfort, oxygen-consuming, wound infection; increased surgical bleeding, and morbid cardiac events. The aim of this study was to determine the magnitude and associated factors of intraoperative shivering after cesarean section delivery.
An institution-based cross-sectional study was conducted. A total of 326 willing patients were included in the study after obtaining ethical consent and we have used consecutive sampling techniques. Axillary temperature was recorded preoperatively and in the intra-operative period every 5 min. Descriptive statistics, cross-tabs, and binary logistic regression analysis were performed to identify the association shivering and independent variables. The strength of the association was presented using an adjusted odds ratio with a 95% confidence interval and a p-value<0.05 was considered as statistically significant.
The overall incidence of intraoperative shivering after cesarean section delivery under spinal anesthesia was 51.8% (95% CI: 46.3, 57.1). The majority of the patients who developed shivering were after 20 min of spinal anesthesia. In this study body temperature, mean arterial pressure of the patient, and duration of surgery were significantly associated with shivering.
In this study duration of surgery, hypothermia and hypotension were the independent associated risk factors for intraoperative shivering.
寒战是骨骼肌的一种不自主、自发且重复性的收缩,会增加患者的不适感、耗氧量、伤口感染几率;增加手术出血量以及引发心脏不良事件。本研究的目的是确定剖宫产术后术中寒战的发生率及相关因素。
进行了一项基于机构的横断面研究。在获得伦理批准后,共有326名自愿参与的患者纳入研究,采用连续抽样技术。术前及术中每隔5分钟记录腋温。进行描述性统计、交叉表分析和二元逻辑回归分析,以确定寒战与自变量之间的关联。关联强度用调整后的比值比及95%置信区间表示,p值<0.05被认为具有统计学意义。
腰麻下剖宫产术后术中寒战的总体发生率为51.8%(95%CI:46.3,57.1)。大多数发生寒战的患者是在腰麻20分钟后。在本研究中,患者体温、平均动脉压和手术时长与寒战显著相关。
在本研究中,手术时长、体温过低和低血压是术中寒战的独立相关危险因素。