A comparative study of pharmacological versus nursing interventions in the treatment of postanesthesia shivering

Postanesthesia shivering (PS) is a potential complication for any surgical patient requiring anesthetic agents. PS has been shown to increase oxygen consumption up to sevenfold, compromising patient oxygenation in the postanesthesia period. The purpose of this study was to compare the effectiveness of radiant heat, radiant heat plus meperidine, and radiant heat plus fentanyl in the treatment of PS in PACU patients. An experimental design study using three groups was conducted using the Neuman Systems Model as a conceptual framework. Twenty-nine subjects were randomized into three groups and were blinded to the treatment, as was the investigator. All subjects received one blanket and radiant heat. Groups I, II, and III received the following respective treatments: normal saline, meperidine (12.5 mg every 5 minutes up to a maximum of 50 mg), and fentanyl (25 micrograms every 5 minutes up to a maximum of 100 micrograms). Data collection included surface electromyography, mean arterial pressure (MAP), heart rate (HR), rate-pressure product (RPP), respiratory rate, and oxygen saturation every 5 minutes until shivering stopped or maximum drug dosages were reached. Data showed no statistically significant differences among the three groups with regard to effectiveness of treatment (F = .507, P = .61). Significant reductions in MAP, HR, RPP, and respiratory rate were found (P = .001) at the end of shivering. Significant differences were also found between the shivering and nonshivering subjects with regard to length of anesthesia, age, body surface area (P less than .01), weight, body mass index (P less than .001), and intravenous fluid administration (P less than .05). Results suggest that radiant heat is as effective alone as it is in combination with pharmacological intervention for the treatment of PS.