Amsalu Hunde, Zemedkun Abebayehu, Regasa Teshome, Adamu Yayeh
Department of Anesthesia, Wachemo University, Hosaena, Ethiopia.
Department of Anesthesiology, Dilla University, Dilla, Ethiopia.
Int J Gen Med. 2022 Sep 5;15:6985-6998. doi: 10.2147/IJGM.S370439. eCollection 2022.
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.
To develop evidence-based recommendations for the prevention and management of shivering after spinal anesthesia in a resource-limited settings.
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).
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.
围手术期寒战是麻醉实践中常见的问题。除非得到妥善处理和预防，否则会引起不适并导致严重问题，尤其是对有心肺问题的患者。手术、麻醉、在寒冷的手术室中暴露皮肤以及输入未加温的液体是外科患者发生寒战的一些主要原因。目前，有多种非药物和药物技术可用于预防和处理这个问题。预防和治疗寒战的可用方法包括但不限于在麻醉给药前对患者进行15分钟的预加温、给予小剂量氯胺酮、地塞米松、哌替啶、可乐定、右美托咪定、曲马多和硫酸镁。
为资源有限环境下脊髓麻醉后寒战的预防和管理制定基于证据的建议。
从谷歌学术、PubMed、Cochrane图书馆和HINARI数据库检索各类文献，以获取脊髓麻醉后寒战预防和管理的最新证据。文献检索的关键词为（寒战或预防）且（寒战或管理）且（麻醉或寒战）。
在脊髓麻醉前15分钟用棉花、毯子、手术衣加温给患者预加温以及输注温静脉液体是预防寒战的可能的非药物选择。此外，小剂量氯胺酮、地塞米松、硫酸镁和曲马多等药物可作为资源有限地区不同程度寒战预防和管理策略的替代选择。
