Effects of extremity wraps to control drug-induced shivering: a pilot study

Efficacy of a nursing intervention to control amphotericin B-induced, febrile shivering was tested in 40 hospitalized adult patients with cancer. Extremity wraps were used to modify the rate of heat loss from skin to prevent shivering stimulus. Duration of shivering and amount of meperidine required for shivering suppression were compared between treatment and control groups. Total shivering duration was shorter in the treatment group than in the control, p less than .005. Less meperidine was administered to the treatment group than to controls but differences were not statistically significant. The fact that nurses differ in their propensity to use a narcotic to treat shivering may make use of meperidine a poor measure of the intervention's efficacy. Shivering was found to significantly affect myocardial oxygen consumption (MVO2) among subjects who shivered. MVO2, as reflected in the rate pressure product, was found to be significantly higher during shivering (p less than .0001) than at pre- or postshivering periods.