Prevalence and risk factors for postanaesthetic shivering

Abstract

Postanaesthetic shivering is one of the common complications affecting patients who undergo surgical procedure in operation theatre. Shivering can occur in patients who received either general or neuroaxial anaesthesia. Although it is not a major complication, it gives negative consequences to patient, might delay in wound healing and cause interruption in vital signs monitoring perioperatively. We conducted this study to determine the prevalence and to find the potential risk factors that might contribute to the occurrence of postanaesthetic shivering in our operation theatre. Patients who were planned for surgery, either elective or emergency that fulfilled the inclusion criteria were recruited in this study involving 143 patients. Demographic characteristics, details of surgery and anaesthesia and occurrence of postanaesthetic shivering were documented and analyzed. The prevalence of postanaesthetic shivering in our operation theatre was 18.9%. Chi-square Test analysis of demographic characteristic showed race contributed to the postanaesthetic shivering with p value of 0.038. By using Multiple Logistic Regression Analysis, Malay has 6.71 times odds of postanaesthetic shivering as compared to other ethnic group. Increased anaesthesia duration and intraoperative lowest core body temperature (˚C) was shown to increase the odds of postanaesthetic shivering by 1.007 and 0.441 times prospectively. Subjects with comorbidities had 3.689 times odds of postanaesthetic shivering as compared to those without. Subjects with Diabetes Mellitus and who received Morphine had 0.189 and 0.158 times odds of postanaesthetic shivering as compared to those who do not. Based on Multivariate Analysis of Variance, using the Wilk’s Lambda test and an alpha level of 0.05, this test is significant (Wilk’s = 0.95, F (2,142) =3.683, p = 0.028 < 0.05). This study concluded that intraoperative lowest core body temperature and postoperative core body temperature were associated with occurrence of postanaesthetic shivering. The prevalence of postanaesthetic shivering in our centre is considered low as compared to previous study conducted in Malaysia. Several factors were identified to cause postanaesthteic shivering which are ethnicity, duration of anaesthesia, intraoperative lowest core body temperature, patients with multiple comorbidities and patients who received Morphine as intraoperative analgesia.