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thakurdaSend an Instant Message to thakurda  




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Quick Scroll Re: during GA shivering is abolished by 08.30.06 (1 year ago) #11
docsa wrote:
during GA shivering is abolished by
icon_question.gif icon_question.gif


dear moderator,

please clarify the question re the following points:-

1. do you mean the suppression of normal shivering response to the
ensuing hypothermia during GA
2. Mx of shivering during / after Anaesthesia eg 'halothane shakes'
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Quick Scroll 09.16.06 (1 year ago) #12
dr_prashant108 wrote:
generally diazepam is given in case there is shivering.

sorry frnd,
very late resort drug to prevent shivering during Anaesthesia ...
First give 100% O2 to prevent myocardial strain...then look for hypo thermia....then check whether it is shivering/seizure/fasciculations.....???
we normally use
1.Tramadol..most successful
2.Fentanyl..very good
3.Fortwin+Anxol[pentazocine+diazepam]
4.Phenergan.
Theoretically you can also use ondansetron to prevent shivering in GA,as it is acting on serotonin receptors and uptil my knowledge shivering has something to do with serotonin basically.
My postgraduate teacher also told me that we can use mephentermine too[???!!!] to prevent shivering in spinal Anaesthesia ...as shivering in spinal is because of compensatory vasoconstriction to counteract the peripheral vasodilation produced by sympathetic block...
And one of my secrets frnd...in very unco-operative patient...after trying all that warming facilities+above mentioned drugs+IV luke warm fluids....I am using a short dose of ketamine along with midazolam...Ketamine will give the patient a bit dissociation+Midazolam helps by deepening that dissociation along with amnesia....But remember very low doses....
One more interesting thing which I have come across is,shivering is also because of incomplete analgesia...it is the misrepresentation of pain via shivering...so you can use analgesics too...I think ketamine works by this mechanism plus the above mentioned tramadol like effect....
Still a lot to say..but this is what I know a bit..
Some also use calcium and steroids too...so it depends on which drug u hv ur confidence...for me....I always use tramadol first and if tramadol is not available then anxol+fortwin,and if not relieved ..the master combination of ketamine with midazolam...
Big Bros,pls correct me if I hv said anything wrong...but don't ask for a reference...
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Quick Scroll 10.02.06 (1 year ago) #13
pethidine is the drug of choice in anaeshteic induced shivering. this q was asked in aipg 2006.
find the complete explanation in brunos rxpg 2006,which is a masterpiece of knoledge
dr.jaya
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Quick Scroll 10.13.06 (1 year ago) #14
som imp points

Shivering is a protective mechanism as the inhalational agents,spinal/epidural block Vasodilatation leading to heat loss

Shivering can be abolished by inhibition of hypothalamus

MC seen after halothane

DOC istramadol.Also pethidine/pentazocine can b used

Oxygen inhalation is mandatory

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Quick Scroll DRUG USED FOR SHIVERING 10.13.06 (1 year ago) #15
MORGAN SAYS MEPERIDINE 20-50 mg iv
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Quick Scroll 09.21.07 (9 months ago) #16
it is definately abolished by hypothalamus
it can also be terminated by tramadol icon_rolleyes.gif icon_rolleyes.gif icon_question.gif
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Quick Scroll 10.22.07 (8 months ago) #17
pethidine is the drug of choice to avoid post operative shivering. meperidine is the other name for pethidine.
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Quick Scroll 11.07.07 (8 months ago) #18
pethidine also known as meperidine abolishes shivering in such patients
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Quick Scroll 05.05.08 (2 months ago) #19
PETHIDINE.
REGARDS.
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Quick Scroll post op shivering 05.19.08 (1 month ago) #20
post op- shivering is abolished by giving pethidine or by putting blankets opn teh patient
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