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.
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
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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