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Postoperative shivering: the influence of body temperature
May be related more to peripheral than core temperature and can be reduced by space blanketsPostoperative shivering is common.1 During recovery from anaesthesia increased muscular activity increases oxygen consumption as much as fivefold. Hypoxaemia, lactic acidosis, and hypercarbia may then complicate recovery from anaesthesia,2 at a time when the patient is at risk of hypoxaemia from other causes. Even without these complications patients find shivering uncomfortable, and preventing the syndrome is clearly desirable.
Why do patients shiver postoperatively? It is tempting to assume that heat loss is contributory, exacerbated by peripheral vasodilatation that in turn is induced by volatile anaesthetic agents. Normal thermogenic shivering is initiated by the hypothalamus. Temperature receptors in the skin, viscera, and various levels of the neuraxis provide information on temperature which is processed at multiple levels of the spinal cord and brain before reaching the hypothalamus. Afferent information on temperature from the head and
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