Department of Anesthesiology, Shenzhen Maternity & Child Healthcare Hospital, The First School of Clinical Medicine, Southern Medical University, No.2004 Hongli Road, Shenzhen, 518028, China.
BMC Anesthesiol. 2022 Feb 28;22(1):56. doi: 10.1186/s12871-022-01596-7.
To study the incidence and risk factors of shivering in pregnant women during cesarean section.
We performed a prospective nested case-control study involving parturients scheduled for cesarean sections between July 2018 and May 2021. The overall incidence of intraoperative shivering and its potential risk factors were investigated. The potential risk factors evaluated were pain, anxiety, emergency surgery, transfer from the delivery room, epidural labor analgesia, membrane rupture, labor, and the timing of the surgery. Shivering and body temperature at different time points during the cesarean section were also recorded. The selected seven time points were: entering the operating room, post-anesthesia, post-disinfection, post-delivery, post-oxytocin, post additional hysterotonics, and before leaving the operating room.
We analyzed 212 cesarean section parturients. The overall incidence of shivering was 89 (42.0%). Multivariate logistic regression showed that anxiety, emergency delivery, and transfer from the delivery room to the operating room increased the overall shivering incidence (odds ratio = 1.77, 2.90, and 3.83, respectively). The peak shivering incidence occurred after skin disinfection (63, 29.7%), and the lowest body temperature occurred after oxytocin treatment (36.24 ± 0.30 °C). Stratified analysis of surgery origin showed that emergency delivery was a risk factor for shivering (odds ratio = 2.99) in women transferred from the obstetric ward to the operating room.
Shivering occurred frequently during cesarean sections, with the peak incidence occurring after skin disinfection. Anxiety, emergency delivery, and transfer from the delivery room to the operating room increased the risk of shivering development during cesarean sections.
The study protocol was registered online at China Clinical Registration Center (registration number: ChiCTR-ROC-17010532, Registered on 29 January 2017).
研究剖宫产术中孕妇寒战的发生率和危险因素。
我们进行了一项前瞻性巢式病例对照研究，纳入 2018 年 7 月至 2021 年 5 月期间行剖宫产术的产妇。研究调查了术中寒战的总发生率及其潜在危险因素。评估的潜在危险因素包括疼痛、焦虑、急诊手术、从产房转至手术室、硬膜外分娩镇痛、胎膜破裂、分娩和手术时间。还记录了剖宫产术中不同时间点的寒战和体温。选择了七个时间点：进入手术室、麻醉后、消毒后、胎儿娩出后、催产素后、额外子宫收缩剂后和离开手术室前。
我们分析了 212 例剖宫产产妇。寒战总发生率为 89（42.0%）。多因素 logistic 回归显示，焦虑、急诊分娩和从产房转至手术室增加了总体寒战发生率（比值比分别为 1.77、2.90 和 3.83）。皮肤消毒后寒战发生率最高（63，29.7%），催产素治疗后体温最低（36.24±0.30°C）。手术来源的分层分析显示，从产科病房转至手术室的产妇中，急诊分娩是寒战的危险因素（比值比为 2.99）。
剖宫产术中寒战频繁发生，皮肤消毒后寒战发生率最高。焦虑、急诊分娩和从产房转至手术室增加了剖宫产术中寒战发生的风险。
研究方案在中国临床试验注册中心在线注册（注册号：ChiCTR-ROC-17010532，注册于 2017 年 1 月 29 日）。
