Abstract
We aim to investigate the effect of Shenfu injection before anesthesia on shivering and its impact on hemodynamic parameters. Eighty patients underwent transurethral resection of the prostate were randomized and received 50 mL Shenfu injection (experiment group) or 50 mL 0.9% sodium chloride injection (control group) before anesthesia. Incidence of shivering, axillary temperature, heart rate, systolic and diastolic blood pressure were monitored before, during, and after surgery. Compared to the control group, patients in the experiment group had significantly less decrease in temperature (36.02 ± 0.29 °C in the experiment group versus 35.50 ± 0.33 °C in the control group, p = 0.047). Patients in the experiment group had lower incidence of shivering (10% in the experiment group versus 27.5% in the control group, p = 0.042). On average, patients in the experiment group had significantly more stable hemodynamic parameters: with lower heart rate, less decrease in systolic and diastolic blood pressure (p < 0.05 for all). No significant difference in adverse events were observed. Our study demonstrated that among elderly patients who received transurethral resection of prostate under combined spinal and epidural anesthesia, Shenfu injection before anesthesia prevented postoperative shivering and reduced the temperature and hemodynamic perturbation of anesthesia and surgery.
Highlights
Shivering is a common complication of anesthesia with incidence rate reported to be between 26% and 74% in the general anesthesia (Eberhart et al, 2005)
Shivering might be associated with several adverse events to both healthy individuals and hospitalized patients who are recovering from anesthesia or treated with hypothermia (Park et al, 2012)
Strenuous shivering can triple oxygen consumption and increase production of carbon dioxide, which might result in demand ischemia in patients with limited pulmonary or cardiac reservation (Kang et al, 2019; Wada et al, 2019)
Summary
Shivering is a common complication of anesthesia with incidence rate reported to be between 26% and 74% in the general anesthesia (Eberhart et al, 2005). Shivering is uncomfortable to patients (Ostheimer & Datta, 1981). It might worsen post operation pain by stretching surgical incisions (Crossley, 1992). Shivering increases consumption of oxygen, production of carbon dioxide, and release of catecholamine, which result in increased cardiac output, arterial pressure and heart rate (Bicer et al, 2006). These conditions might impose extra risk on patients with existing cardiac or pulmonary conditions. Effective prevention and treatment of shivering are essential in increasing postoperative comfort and reducing shivering related complications
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