Factors associated with postoperative shivering in patients with maintained core temperature after surgery

Abstract Background Postoperative shivering is mainly associated with low body temperature. However, postoperative shivering can develop even at normal or high core temperatures. This study aimed to investigate the factors associated with postoperative shivering in patients with maintained core temp...

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Main Authors: Kazuhiro Shirozu, Masako Asada, Ryotaro Shiraki, Takuma Hashimoto, Ken Yamaura
Format: Article
Language:English
Published: SpringerOpen 2024-11-01
Series:JA Clinical Reports
Subjects:
Online Access:https://doi.org/10.1186/s40981-024-00755-8
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author Kazuhiro Shirozu
Masako Asada
Ryotaro Shiraki
Takuma Hashimoto
Ken Yamaura
author_facet Kazuhiro Shirozu
Masako Asada
Ryotaro Shiraki
Takuma Hashimoto
Ken Yamaura
author_sort Kazuhiro Shirozu
collection DOAJ
description Abstract Background Postoperative shivering is mainly associated with low body temperature. However, postoperative shivering can develop even at normal or high core temperatures. This study aimed to investigate the factors associated with postoperative shivering in patients with maintained core temperature after surgery. Methods This retrospective study involved 537 patients who had undergone radical surgery for pancreatic cancer under general anesthesia from January 2013 to December 2023. The final analysis included 441 patients whose core temperatures after surgery were ≥ 36.5℃. Logistic regression analysis was performed to estimate the odds ratio (OR) of the incidence of postoperative shivering. Results Postoperative shivering occurred in 119 patients. After multivariable-adjusted logistic regression, postoperative shivering was significantly associated with patient age (per 1 year increase; OR = 0.98; 95% confidence interval [CI]: 0.96–0.996; p = 0.02), operation time (per 30 min increase; OR = 1.10; 95% CI: 1.01–1.19; p = 0.03), postoperative core temperature (restricted cubic spline, p = 0.001), postoperative peripheral temperature (restricted cubic spline, p = 0.001), effect site fentanyl concentration at extubation (OR = 0.66; 95% CI: 0.24–0.99; p = 0.049), and acetaminophen use (OR = 0.32; 95% CI: 0.18–0.58; p < 0.001). Conclusions Low peripheral temperature was a risk factor for the occurrence of shivering, even if the core temperature was maintained postoperatively. Peripheral temperature monitoring could be utilized to prevent postoperative shivering. In addition, fentanyl and acetaminophen reduced the occurrence of shivering in patients with maintained core temperature after surgery.
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spelling doaj-art-ce2816e4814f43068c4b88c66a4b13cf2024-11-17T12:14:24ZengSpringerOpenJA Clinical Reports2363-90242024-11-011011710.1186/s40981-024-00755-8Factors associated with postoperative shivering in patients with maintained core temperature after surgeryKazuhiro Shirozu0Masako Asada1Ryotaro Shiraki2Takuma Hashimoto3Ken Yamaura4Operating Rooms, Kyushu University HospitalDepartment of Anesthesiology and Critical Care Medicine, Kyushu University Graduate School of MedicineDepartment of Anesthesiology and Critical Care Medicine, Kyushu University HospitalDepartment of Anesthesiology and Critical Care Medicine, Kyushu University HospitalDepartment of Anesthesiology and Critical Care Medicine, Kyushu University Graduate School of MedicineAbstract Background Postoperative shivering is mainly associated with low body temperature. However, postoperative shivering can develop even at normal or high core temperatures. This study aimed to investigate the factors associated with postoperative shivering in patients with maintained core temperature after surgery. Methods This retrospective study involved 537 patients who had undergone radical surgery for pancreatic cancer under general anesthesia from January 2013 to December 2023. The final analysis included 441 patients whose core temperatures after surgery were ≥ 36.5℃. Logistic regression analysis was performed to estimate the odds ratio (OR) of the incidence of postoperative shivering. Results Postoperative shivering occurred in 119 patients. After multivariable-adjusted logistic regression, postoperative shivering was significantly associated with patient age (per 1 year increase; OR = 0.98; 95% confidence interval [CI]: 0.96–0.996; p = 0.02), operation time (per 30 min increase; OR = 1.10; 95% CI: 1.01–1.19; p = 0.03), postoperative core temperature (restricted cubic spline, p = 0.001), postoperative peripheral temperature (restricted cubic spline, p = 0.001), effect site fentanyl concentration at extubation (OR = 0.66; 95% CI: 0.24–0.99; p = 0.049), and acetaminophen use (OR = 0.32; 95% CI: 0.18–0.58; p < 0.001). Conclusions Low peripheral temperature was a risk factor for the occurrence of shivering, even if the core temperature was maintained postoperatively. Peripheral temperature monitoring could be utilized to prevent postoperative shivering. In addition, fentanyl and acetaminophen reduced the occurrence of shivering in patients with maintained core temperature after surgery.https://doi.org/10.1186/s40981-024-00755-8ShiveringPeripheral temperatureCore temperatureAcetaminophen
spellingShingle Kazuhiro Shirozu
Masako Asada
Ryotaro Shiraki
Takuma Hashimoto
Ken Yamaura
Factors associated with postoperative shivering in patients with maintained core temperature after surgery
JA Clinical Reports
Shivering
Peripheral temperature
Core temperature
Acetaminophen
title Factors associated with postoperative shivering in patients with maintained core temperature after surgery
title_full Factors associated with postoperative shivering in patients with maintained core temperature after surgery
title_fullStr Factors associated with postoperative shivering in patients with maintained core temperature after surgery
title_full_unstemmed Factors associated with postoperative shivering in patients with maintained core temperature after surgery
title_short Factors associated with postoperative shivering in patients with maintained core temperature after surgery
title_sort factors associated with postoperative shivering in patients with maintained core temperature after surgery
topic Shivering
Peripheral temperature
Core temperature
Acetaminophen
url https://doi.org/10.1186/s40981-024-00755-8
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AT ryotaroshiraki factorsassociatedwithpostoperativeshiveringinpatientswithmaintainedcoretemperatureaftersurgery
AT takumahashimoto factorsassociatedwithpostoperativeshiveringinpatientswithmaintainedcoretemperatureaftersurgery
AT kenyamaura factorsassociatedwithpostoperativeshiveringinpatientswithmaintainedcoretemperatureaftersurgery