Murphy M T, Lipton J M, Loughran P, Giesecke A H
Anesthesiology. 1985 Aug;63(2):161-5. doi: 10.1097/00000542-198508000-00008.
There has been little research on the cause(s) of postanesthetic shivering (PAS) and on specific interventions. Therefore, the authors investigated PAS in eight unoperated squirrel monkeys anesthetized with halothane-nitrous oxide mixture. Shivering developed in all monkeys in which body temperature was allowed to decrease (mean +/- SEM, 2.8 +/- 0.6 degrees C) during anesthesia. Shivering occurred in 25% of animals in which body temperature was actively maintained at preanesthetic levels during anesthesia. No shivering occurred in animals warmed both during and after anesthesia. Application of radiant heat to the skin stopped PAS immediately, even though deep body temperature remained low; shivering resumed within seconds after this heating was discontinued. Intracerebroventricular (0.1-2 mg) and intravenous (100 mg/kg) administration of the putative inhibitory neurotransmitter taurine also stopped the shivering in preliminary experiments, but central injection of alpha-melanocyte stimulating hormone (100-300 micrograms), an endogenous antipyretic, did not. The results implicate reduced body temperature and activation of central heat production pathways as major factors in PAS and suggest that halothane-nitrous oxide anesthesia per se, elevation of the thermal set-point, and surgical procedures are not essential to the shivering phenomenon. The results suggest for future study two methods to control PAS: application of radiant heat or administration of taurine.
关于麻醉后寒战(PAS)的病因及具体干预措施的研究甚少。因此,作者对八只未接受手术的松鼠猴进行了研究,这些猴子采用氟烷 - 氧化亚氮混合气体麻醉。在麻醉期间,所有体温下降的猴子(平均±标准误,2.8±0.6℃)均出现了寒战。在麻醉期间体温被积极维持在麻醉前水平的动物中,25%出现了寒战。在麻醉期间及麻醉后均进行保暖的动物未出现寒战。对皮肤施加辐射热可立即停止PAS,即便深部体温仍较低;停止加热后数秒内寒战又会恢复。在初步实验中,脑室内注射(0.1 - 2毫克)及静脉注射(100毫克/千克)假定的抑制性神经递质牛磺酸也可停止寒战,但脑室内注射内源性解热物质α - 黑素细胞刺激素(100 - 300微克)则不能。结果表明体温降低和中枢产热途径的激活是PAS的主要因素,并提示氟烷 - 氧化亚氮麻醉本身、体温调定点升高及外科手术对寒战现象并非必不可少。结果为未来控制PAS的研究提示了两种方法:施加辐射热或给予牛磺酸。