Shivering Clinical Trial
Official title:
Relationship Between Core-peripheral Temperature Difference and Shivering Symptom in Patients in PACU
Shivering is a physiologic response to early hypothermia in mammals. The definition of
shivering is an involuntary, oscillatory muscular activity that augments metabolic heat
production.
Routinely in post anesthetic care unit (PACU), the core temperature via tympanic membrane is
always measured in all patients. Sometimes patients who have low temperature have no
shivering symptom in other hand patients who have normal temperature have shivering symptom.
This indicates that, only core temperature is not enough for predicting or detecting
patients who will have shivering symptom in PACU.
In this study, investigators hypothesise that the core-peripheral temperature difference in
postoperative period indicates patients who will have shivering symptom.
Thus, the aims of this study are to evaluate the relationship between core-peripheral
temperature difference and shivering symptom in patients in PACU.
Humans are warm-blooded animal or homeotherms. They are able to regulate their body
temperature which in physiologic range themselves. The body temperature is controlled by
balancing heat production and heat loss. The normal body temperature refers to either core
temperature (eg. tympanic membrane, esophagus, and intra-urinary bladder) or peripheral
temperature (eg. skin, forehead, and axillar). Core temperature is the temperature of the
deep tissues of the body. The normal range of core temperature is between 36.5-37.5 degree
celsius. The peripheral temperature, in contrast to the core temperature, can be changed by
many factors such as the temperature of the surroundings environment.
The term of hypothermia is the core temperature less than or equal to 36.4 degree celsius.
When the body exposes to cold temperature, heat loss is decreased and heat production is
increased as defense mechanism for keeping balance in several means: stop sweating,
piloerection, cutaneous arterioles constriction, shivering, which increases heat production
in skeletal muscles, conversion from fat to energy by mitochondria.Hypothermia is one of
factors, which relates to postoperative complications.
Shivering is an oscillatory muscular activity that augments metabolic heat production.
Vigorous shivering increases metabolic heat production up to 600% above basal level.
Shivering is a common postoperative period complication. The pathophysiology of
postoperative shivering remains unclear otherwise various mechanisms have been proposed.
Shivering may happen as a thermoregulatory response to hypothermia or muscle hyperactivity
with clonic or tonic patterns. Although cold-induced shivering is an obvious source of
postanesthetic tremor. Some of the patients who suffer from shivering are believed to be
nonthermoregulatory because their core temperatures remain normal. The incidence of
postoperative shivering is 65% of patients after general anesthesia and 33% of patients
after regional anesthesia.
This is the prospective observation clinical study. Investigators will observe shivering
symptom and measure the patients' temperature at tympanic membrane, forehead, and dorsal of
hand at many time points.
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