Shivering during or after surgery can have a number of significant adverse effects on a surgical patient. A patient at risk for significant adverse effects should be targeted for prophylactic therapy.


Adverse Effect

Patient at Risk

increased metabolic demands (up to 4 to 5 fold) with lactic acidosis

malnutrition, shock, diabetes mellitus, preoperative acidosis

increased oxygen demand with hypoxemia and increased carbon dioxide, driving increased respiration

moderate to severe cardiac disease, moderate to severe lung disease, thoracic surgery patient

increased intra-ocular pressure


increased pain


psychological distress to the patient

mentally ill or retarded

difficulty in monitoring

critically ill patient


Some drug therapies for shivering can act synergistically with opioid analgesics to cause respiratory depression if administered in high doses.


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