[Shivering and rigor during the awakening period]

Muscular hyperactivity presenting as shivering and rigor during the awakening period after 116 surgeries with the use of microsurgical technique under balanced NLA-based anesthesia was studied. In some cases ketamine (0.5 to 0.75 mg/kg) and trilene (0.3 to 0.5 vol.%) were used at the stage of tissue revascularization under conditions of controlled and uncontrolled thermal loss. The efficacy of special drug (ketamine, trilene) and nondrug (warming measures) components of anesthesia preventing shivering and rigor was demonstrated. A correlation between the intensity of muscular hyperactivity and the degree of recovery of pain sensitivity (r from -0.73 to -0.98) and the level of consciousness recovery (r from 0.69 to 0.92) was revealed. The policy of treatment of shivering and chill was selected with due consideration for these data. Efficacies of tramal (96%) and ketamine (80%) were demonstrated. Nubain was found absolutely unfit for the purpose.