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LETTER TO THE EDITOR
Year : 2011  |  Volume : 1  |  Issue : 2  |  Page : 96

Post spinal shivering: A troublesome problem


Department of Anaesthetic, National Health Service, Princess Royal Maternity Unit, Glasgow Royal Infirmary, Glasgow, United Kingdom

Date of Web Publication17-Mar-2012

Correspondence Address:
Stuart Hannah
Department of Anaesthetic, Princess Royal Maternity Unit, Glasgow Royal Infirmary, Glasgow, G31 2ER
United Kingdom
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2249-4472.93996

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How to cite this article:
Hannah S, Junkin R. Post spinal shivering: A troublesome problem. J Obstet Anaesth Crit Care 2011;1:96

How to cite this URL:
Hannah S, Junkin R. Post spinal shivering: A troublesome problem. J Obstet Anaesth Crit Care [serial online] 2011 [cited 2018 May 26];1:96. Available from: http://www.joacc.com/text.asp?2011/1/2/96/93996

Sir,

We read with interest the study by Drs Reddy and Chiruvella, [1] which concluded that clonidine was less-effective than tramadol in the treatment of post spinal shivering. This paper was presented and discussed at our local departmental meeting.

We would like to say that, in our experience, we agree that post spinal shivering is a very common and significant problem. Indeed, the incidence is likely to increase given the rising cesarean section rates and the general acceptance of regional anesthesia as the standard anesthetic technique.

We have found that patients often attribute significant anxiety to shivering after regional techniques and require additional reassurance intraoperatively. It also impacts on the initial bonding between mother and baby when it persists into the immediate postoperative period. This has a negative impact on the overall patient experience. Informed discussion of this side-effect prior to administration of a regional technique, although not a treatment per se, may be helpful in reducing the incidence of patient dissatisfaction.

We would like to bring to the authors' attention a similar study by Shukla et al.[2] published earlier this year. In contrast, they found that clonidine and tramadol were both equally effective at treating post spinal shivering. However, the time to cessation of shivering in the clonidine group was significantly shorter (2.54 ± 0.76 and 5.01 ± 1.02 min, respectively [P = 0.0000001]). This study however did not look at patients who underwent cesarean section and therefore results may not be directly comparable.

We have also observed that the problem of shivering occurs frequently in those patients who have received epidural anesthesia for cesarean section. It may be useful to do a further study of treatments for shivering in this context.

Overall, we would like to congratulate the authors on an interesting piece of work that recognises this problem and that we hope can influence our practice locally.

 
  References Top

1.Reddy VS, Chiruvella S. Clonidine versus tramadol for post spinal shivering during caesarean section: A randomized double blind clinical study. J Obstet Anaesth Crit Care 2011;1:26-9.  Back to cited text no. 1
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2.Shukla U, Malhotra K, Prabhakar T. A comparative study of the effect of clonidine and tramadol on post-spinal anaesthesia shivering. Indian J Anaesth 2011;55:242-6.  Back to cited text no. 2
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