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PubMed1992

[The use of nefopam in the prophylaxis and treatment of postoperative shivering].

Chlorhydrate nefopam was used in the prophylaxis and treatment of postoperative shivering in 54 patients undergoing general anesthesia for radical cystectomy with trans-intestinal anastomosis. Postoperative shivering was not observed in any of the patients treated with nefopam before coming round, whereas it occurred in 55% of patients treated with placebo. Chlorhydrate nefopam subsequently stopped shivering in all these patients. The main side effects observed took the form of delayed awakening in 11% of patients receiving prophylactic treatment and somnolence lasting 5-10 minutes in all other patients.

Adult↗
PubMed1991

[The effect of prostaglandin E1 (PGE1) on body temperature and on postoperative shivering under high dose epidural fentanyl].

Ninety-nine elective abdominal surgeries were performed under high dose epidural fentanyl anesthesia. PGE1 (0.02 microgram.kg-1.min-1 = 0.02 gamma) was administered to 34 patients (0.02 gamma group), and PGE1 (0.05 gamma) was administered to 16 patients (0.05 gamma group). PGE1 was not administered to 49 patients (control group). The effect of PGE1 on body temperature and on postoperative shivering was compared within three groups. In the 0.02 gamma group, the temperature of the fingertip was significantly higher and the rectum-fingertip temperature gradient was significantly lower than in the other groups. The forearm-fingertip temperature gradient was lower in the 0.02 gamma and 0.05 gamma groups than in the control group. The incidence of postanesthetic shivering was significantly lower in the 0.05 gamma group than in the other groups. These results suggest that; 1) PGE1 (0.02 gamma and 0.05 gamma groups) affects the peripheral blood flow and peripheral temperature, and 2) PGE1 (0.05 gamma group) significantly affects the incidence of postanesthetic shivering.

Abdomen↗
PubMedDate not supplied

[Clonidine and postoperative shivering].

Clonidine was clinically evaluated to suppress postoperative shivering in 60 patients who had undergone anesthesia for general, thoracic and vascular surgery. The study was carried out in double blind conditions with comparison of two doses (75 and 150 micrograms) of clonidine, one dose of methylphenidate, and one dose of saline, as control group. The level of inhibition (Goldfarb scale), haemodynamics and temperature were studied. In conclusion, the methylphenidate is drug first choice for postoperative shivering, but clonidine inhibits postoperative shivering without haemodynamic and temperature variations (75 micrograms).

Adolescent↗
PubMed1979

[Role of the fusimotor system in regulating shivering].

Spontaneously active gamma-motoneurons were found in muscles of the cat during shivering. The activity of these gamma-motoneurons could be increased by stimulation of thermoreceptors of the subcutaneous vessels and nociceptors. Administration of oxotremorine, nicotin, phentolamine, isoprenaline, and seduxene into the 3rd brain ventricle suppressed the shivering but did not change the firing rate of the gamma-motoneurons. The fusomotor system seems to participate in the segmentary activation of shivering, but not in its supraspinal control.

Animals↗
PubMed1990

The use of tramadol hydrochloride in the treatment of post-anesthetic shivering.

Tramadol at the dosage of 1 mg per kg body weight was given intravenously to 110 adult patients who developed postoperative shivering. All patients were cured of the shivering after 45 seconds to 6 minutes. Seventy-four per cent stopped within 2 minutes after the injection. There were five patients who had recurrence of shivering after 10 to 30 minutes and this was easily stopped by another dosage of the drug. There were very few minor side effects and they required no medical treatment.

Adolescent↗
PubMedDate not supplied

Temperature changes and shivering after epidural anesthesia for cesarean section.

Changes in bladder, tympanic membrane, and skin temperature were monitored in two groups of parturients after they received epidural anesthesia for elective Cesarean sections. Group 2 patients (n = 21) received warm intravenous crystalloid and prep solutions as well as extra body covering, whereas Group 1 patients (n = 19) did not. The drop in bladder temperature over the course of the procedure was significantly greater in Group 1 patients (1.0 +/- .02 degrees C vs. 0.6 +/- 0.01 degrees C, SEM p less than 0.05). The incidence of shivering was similar in both groups (52% vs. 68%, x2 = 0.42). The peak onset of shivering occurred within 10 minutes of epidural anesthesia and preceded any significant decline in core temperature. However, a positive correlation was noted between shivering and bladder temperature decline over the full course of Cesarean section.

Adult↗
PubMed1985

The effect of ketanserin on post-anaesthetic vasoconstriction and shivering.

Two homogeneous groups of 20 healthy women submitted to elective gynaecological surgery, who presented after anaesthesia with peripheral vasoconstriction and shivering, were included in a randomized, double-blind study. The first group received 10 mg ketanserin, a new pure antagonist of serotoninergic S2 receptors. The second group received 10 ml saline as placebo. Blood pressure, heart rate, pulse wave amplitude, and rectal and cutaneous temperatures were measured before and 5, 15 and 30 min after treatment. Vasoconstriction, shivering and discomfort were classified as intense, moderate or absent at these times. Venous and arterial blood gases were determined before and 15 min after treatment. Blood pressure and heart rate decreased slightly after ketanserin administration and this decrease was statistically significant. Increases in rectal temperature were similar in both groups. Peripheral temperature, measured in the big toe, significantly decreased in the placebo group but did not change after ketanserin. Vasoconstriction, shivering, discomfort and pulse wave amplitude improved significantly following ketanserin. We conclude that ketanserin may be effective in treating this post-operative complication, the possible mechanism being the vasodilatation it causes; a central serotoninergic blockade could also be implied.

Adult↗
PubMed1979

The effect of dopamine on shivering in the rat.

1. Dopamine (0.5--0.2 mumole) injected into a lateral cerebral ventricle inhibited shivering and lowered core temperature in rats at an ambient temperature of 0--5 degrees C. 2. These effects were inhibited by the dopamine antagonist, pimozide, and imitated by the dopamine agonists, piribedil and apomorphine. 3. Pimozide itself had no effect on shivering. 4. It is concluded that while there are inhibitory dopamine receptors on the cold sensor--shivering pathway in the rat they are not concerned in the normal function of this pathway.

Animals↗
PubMed1981

[Intercostal muscle motor unit activity during shivering].

The activity of single motor units of the intercostal muscles has been studied during reactions of thermoregulation in cats. It has been shown that during shivering both respiratory and tonic units are functioning with a frequency of discharges of 5--12/sec. A marked increased in the quantity of active tonic motor units was revealed in shivering. During warming of the animal and cessation of shivering first the tonic units and then the respiratory ones ceased to discharge. The thermoregulatory function of the intercostal muscles seems to be achieved essentially by tonic motoneurons activated by cold stimulation.

Animals↗
PubMedDate not supplied

[Shivering and rigor during the awakening period].

Muscular hyperactivity presenting as shivering and rigor during the awakening period after 116 surgeries with the use of microsurgical technique under balanced NLA-based anesthesia was studied. In some cases ketamine (0.5 to 0.75 mg/kg) and trilene (0.3 to 0.5 vol.%) were used at the stage of tissue revascularization under conditions of controlled and uncontrolled thermal loss. The efficacy of special drug (ketamine, trilene) and nondrug (warming measures) components of anesthesia preventing shivering and rigor was demonstrated. A correlation between the intensity of muscular hyperactivity and the degree of recovery of pain sensitivity (r from -0.73 to -0.98) and the level of consciousness recovery (r from 0.69 to 0.92) was revealed. The policy of treatment of shivering and chill was selected with due consideration for these data. Efficacies of tramal (96%) and ketamine (80%) were demonstrated. Nubain was found absolutely unfit for the purpose.

Adult↗
PubMed1977

Localization of the brain regions concerned in the inhibition of shivering by trauma.

The effect on the inhibition of shivering by limb ischaemia of small 6-hydroxydopamine (6-OHDA) lesions in the hypothalamus has been studied in rats. The injection of 6-OHDA into the posterior part of the hypothalamus in the neighbourhood of the N. dorsomedialis or into the ventral ascending catecholaminergic bundle caudal to that nucleus prevented the depression of the ambient temperature threshold for the onset of shivering which usually occurs during hind-limb ischaemia and lowered the slope of the regression line relating the intensity of shivering to ambient temperature. In rats not treated with 6-OHDA this slope is unaffected by limb ischaemia. These lesions reproduced the changes seen when 6-OHDA was injected into the lateral cerebral ventricle. Lesions in other parts of the hypothalamus were without effect. It is concluded that the inhibitory catecholaminergic synapses are situated in the posterior part of the hypothalamus and that the impulses reach them from nerve cells in the hind-brain via the ventral bundle. The lesions produced in these experiments had little effect on thermoregulation in non-injured rats.

Animals↗
PubMed1993

Effects of prolonged CO2 inhalation on shivering thermogenesis during cold-water immersion.

We investigated the effect of prolonged hypercapnia on human thermoregulation during immersion of seven male subjects in a 15 degrees C water bath until their esophageal temperature dropped to 35 degrees C or until 1 h had elapsed. In the control trial, subjects inspired room air, whereas in the other trial the inhaled gas mixture was a 4% CO2:20% O2:76% N2 gas mixture. Oxygen uptake (VO2, liter.min-1), inspired minute ventilation (VI, liter.min-1), esophageal temperature (Tes, degree C), mean unweighted skin temperature (Tsk, degree C), mean heat flux (Q, W.m-2), and electromyographic (EMG, mV) activity of the trapezius muscle were recorded. VO2 and integrated EMG (IEMG) activity were used as the primary indicators of shivering thermogenesis. There was a tendency for elevated VO2, albeit not significant, in the CO2 trial compared to the air trial. We observed no significant differences in the IEMG between the air and CO2 trials. These results suggest that prolonged inhalation of a gas mixture containing 4% CO2 does not have a significant inhibitory effect on shivering thermogenesis and does not enhance the cooling rate of the body core. The absence of any shivering attenuation is most likely due to the small blood PCO2 increase incurred by inhalation of 4% CO2, compensation of hypercapnic-induced respiratory acidosis, and a strong thermal drive from core and peripheral regions. It is unlikely that elevated PICO2 levels contribute significantly to the etiology of hypothermia in divers.

Adult↗
PubMed1993

[The treatment of postoperative shivering with nefopam hydrochloride].

After having considered the physiopathological mechanism of shivering, the authors have estimated in a randomised study the effects of the resolution of shivering by nefopam hydrochloride. This drug a dose of 0.20 mg/kg resolved the symptoms in 100% of cases and the placebo hasn't resolved a case so that case it also obtained the same effects. The authors have proved the efficacy of the nefopam hydrochloride in the control of postoperative shivering in the recommended dose.

Adolescent↗
PubMed1995

Heat production during cold water immersion: the role of shivering and exercise in the development of hypothermia.

Immersed in cold water, the body loses heat to the external environment. Heat production rises in order to compensate for heat loss by shivering or exercise. The aim of this study was to determine whether heat production is more successfully maintained over a long period of time by physical activity than by shivering when a human being is wearing an insulated survival suit and is immersed in cold water, and whether increased insulation of those parts of the suit exposed to water improves protection against heat loss with all-around standard insulation of the suit. Nine men participated in four series of experiments each lasting six hours. They were immersed in water at 3.6 degrees C and wore survival suits. One series of trials was made at rest, one series with periods of work, one series at rest where the insulation on the back was increased by 10 mm, and one series at rest with a survival suit featuring a new type of insulation. The results showed that periods of work give better chances of survival than continuous heat production by shivering in a well insulated suit. Furthermore, an extra layer of insulation in the back region significantly improved the thermal status of the subjects. When both rectal and skin temperature change at the same time in the same direction, there is a stronger influence on thermoregulation than when rectal temperature alone changes.

Body Temperature↗
PubMed1997

[The effect of vasodilator on the occurrence of postoperative shivering and the fall of core temperature].

We evaluated the effect of intraoperative vasodilator therapy on the occurrence of postoperative shivering and the fall of core temperature during 37 abdominal operations by the stepwise multiple regression analysis. As the vasodilator, we used PGE1 at the dose of 0.02-0.05 microgram.kg-1.min-1. In the vasodilator group, postoperative peripheral surface temperature was high and the occurrence of shivering was low. And intraoperative and postoperative core temperatures were not affected by that therapy. From these results, we conclude that intraoperative vasodilator therapy suppressed the occurrence of postoperative shivering without a fall of core temperature.

Adult↗
PubMed1997

Alterations in cardiac effort and oxygenation during shivering after cardiac surgery.

This study was undertaken to determine if shivering after cardiac surgery threatens stability during early surgical recovery. Twenty-six subjects were monitored for 6 postoperative hours to identify effects of increasing shivering severity on cardiac effort and peripheral oxygenation. Analyses show that there is an increase in effort and a decrease in tissue oxygenation with increasing shivering severity.

Adult↗
PubMed2006

Increased axonal mitochondrial activity as an adaptation to myelin deficiency in the Shiverer mouse.

Axonal pathology in multiple sclerosis (MS) has been described for over a century, but new insights into axonal loss and disability have refocused interest in this area. There is evidence of oxidative damage to mitochondrial DNA in chronic MS plaques, suggesting that mitochondrial failure may play a role in MS pathology. We propose that in the chronic absence of myelin the maintenance of conduction relies partially on an increase in mitochondria to provide energy. This increased energy requirement also promotes reactive oxygen species (ROS), because most intraaxonal ROS are generated by mitochondria. If antioxidant defenses are overwhelmed by an excess of ROS, this may result in damage to the axon. Our aim was to investigate whether a chronic lack of myelin results in adaptive changes involving mitochondria within the axon. We investigated this in the shiverer mouse. This myelin basic protein gene mutant provides a model of how adult central nervous system (CNS) axons cope with the chronic absence of a compact myelin sheath. Cytochrome c histochemistry demonstrated a twofold increase in mitochondrial activity in white matter tracts of shiverer, and electron microscopy confirmed a significantly higher number of mitochondria within the dysmyelinated axons. Our data demonstrate that there are adaptive changes involving mitochondria occurring within CNS axons in shiverer mice in response to a lack of myelin. This work contributes to our understanding of the adaptive changes occurring in response to a lack of myelin in a noninflammatory environment similar to the situation seen in chronically demyelinated MS plaques.

Adaptation, Physiological↗
PubMed1986

Myelin basic protein-specific protein methylase I activity in shiverer mutant mouse brain.

Myelin basic protein (MBP)-specific protein-arginine N-methyltransferase (protein methylase I) activity in homozygous shiverer (shi/shi) mutant mouse brain is significantly higher than in the normal littermate brain at the onset of myelination. While the enzyme activity (expressed as pmol of S-adenosyl-L-[methyl-14C]methionine used/min/mg enzyme protein) increases coincidently during the period of myelination in the normal brain (15-18 days of age), it decreases significantly in the mutant brain during this period of time. These results are in contrast to those found with another dysmyelinating mutant, jimpy (jp/Y) mice, in which the enzyme activity in the mutant brains is similar to that in the normal animals but remains unchanged during the myelination process. There is no difference in the weight and protein concentration of the normal and shiverer mutant brains with corresponding ages, and the histone-specific protein methylase I activity is also unaffected in the shiverer brain.

Animals↗