Suppression of shivering decreases oxygen consumption and improves hemodynamic stability during postoperative rewarming.
Thirty-three patients undergoing elective myocardial revascularization were prospectively randomized into two study groups (Group S and Group P) to permit evaluation of the effects of shivering on oxygen consumption per minute (VO2), carbon dioxide production per minute (VCO2), and hemodynamic performance. Group S was allowed to shiver during the postoperative rewarming period, and Group P received hourly injections of pancuronium bromide and Metubine (metocurine) sulfate with sedation to block the shivering response. Group S demonstrated significantly higher increases in VO2 and VCO2, lower systolic blood pressure and mixed venous oxygen saturation, and a greater use of inotropic support than the patients in Group P. Suppression of the shivering response minimized increases in VO2 and VCO2, improved hemodynamic stability, and resulted in a decreased need for inotropic support.
D001831:Body Temperature; D002245:Carbon Dioxide / Q000032:analysis; D002315:Cardiopulmonary Bypass; D003975:Diazepam / Q000008:administration & dosage; D004298:Dopamine / Q000008:administration & dosage; D006439:Hemodynamics; D006801:Humans; D007036:Hypothermia, Induced; D009020:Morphine / Q000008:administration & dosage; D010101:Oxygen Consumption; D010197:Pancuronium / Q000008:administration & dosage; D011182:Postoperative Care; D011446:Prospective Studies; D011897:Random Allocation; D012768:Shivering / Q000187:drug effects; D014403:Tubocurarine / Q000008:administration & dosage / Q000031:analogs & derivatives
D002245:Carbon Dioxide; D009020:Morphine; D010197:Pancuronium; D003975:Diazepam; C032943:metocurine; D004298:Dopamine; D014403:Tubocurarine