title: Novamin infusion: a new method to cure postoperative shivering with hypothermia.
abstract: BACKGROUND
  Postoperative shivering is a frequent complication of surgery in developing countries and there is no satisfying method to treat it, let alone to cure it. We studied whether intravenous amino acid (AA) infusion can cure postoperative shivering in the postanesthesia care unit.
  
  
  METHODS
  Sixty postanesthesia care unit patients with shivering grade 2 or higher and tympanic temperature <36°C received randomly either infusion of Novamin 18 AAs (2 mL/kg/h), pethidine (0.5 mg/kg), or tramadol (1 mg/kg). Tympanic temperature, shivering grade, and thermal comfort were assessed every 5 min for 60 min. Blood glucose and lactic acid concentrations were measured before and after treatment. Postoperative nausea and vomiting were also recorded.
  
  
  RESULTS
  Shivering stopped within 5 min in the pethidine and tramadol groups versus 90% stopped within 15 min in AA group. There were five cases of reshivering in the tramadol group versus none in the AA or pethidine groups. Tympanic temperature increased slowly in all patients but increased significantly faster in the AA group. Thermal comfort improved significantly faster in the AA group versus the other two groups, thermal comfort was significantly higher in the tramadol versus the pethidine group ≥35 min. Blood glucose concentration in AA group increased to 135.18 ± 9.18 mg/dL. There were some cases of nausea and vomiting in pethidine and tramadol groups but none in the AA group.
  
  
  CONCLUSIONS
  Novamin infusion can stop postoperative shivering and alleviates hypothermia and improves thermal comfort more effectively than tramadol and pethidine with less nausea and vomiting and causes a clinically acceptable blood glucose increase with no reshivering episodes.
authors.affiliation: Department of Anesthesia, Zhongshan Hospital, Fudan University, Shanghai, China; Department of Anesthesiology, Shanghai Medical College, Fudan University, Shanghai, China.
authors.forename: PeiWen
authors.initials: P
authors.lastname: Zhou
authors.affiliation: Department of Anesthesia, Zhongshan Hospital, Fudan University, Shanghai, China; Department of Anesthesiology, Shanghai Medical College, Fudan University, Shanghai, China. Electronic address: ge.shengjin@fudan.edu.cn.
authors.forename: ShengJin
authors.initials: S
authors.lastname: Ge
authors.affiliation: Department of Anesthesia, Zhongshan Hospital, Fudan University, Shanghai, China; Department of Anesthesiology, Shanghai Medical College, Fudan University, Shanghai, China.
authors.forename: YaDi
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Anesthesia, Zhongshan Hospital, Fudan University, Shanghai, China; Department of Anesthesiology, Shanghai Medical College, Fudan University, Shanghai, China.
authors.forename: WanXia
authors.initials: W
authors.lastname: Xiong
authors.affiliation: Department of Anesthesia, Zhongshan Hospital, Fudan University, Shanghai, China; Department of Anesthesiology, Shanghai Medical College, Fudan University, Shanghai, China.
authors.forename: TingTing
authors.initials: T
authors.lastname: Wang
authors.affiliation: Department of Anesthesia, Zhongshan Hospital, Fudan University, Shanghai, China; Department of Anesthesiology, Shanghai Medical College, Fudan University, Shanghai, China.
authors.forename: ZhangGang
authors.initials: Z
authors.lastname: Xue
mesh_terms: D000328:Adult; D000596:Amino Acids / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000627:therapeutic use; D004573:Electrolytes / Q000627:therapeutic use*; D005260:Female; D005947:Glucose / Q000627:therapeutic use*; D006801:Humans; D007035:Hypothermia / Q000188:drug therapy*; D008297:Male; D008614:Meperidine / Q000627:therapeutic use; D008875:Middle Aged; D057947:Parenteral Nutrition Solutions / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000188:drug therapy*; D012768:Shivering; D012996:Solutions / Q000627:therapeutic use; D014147:Tramadol / Q000627:therapeutic use
chemical_list: D000596:Amino Acids; D000701:Analgesics, Opioid; D004573:Electrolytes; D057947:Parenteral Nutrition Solutions; D012996:Solutions; C545824:amino-acid, glucose, and electrolyte solution; D014147:Tramadol; D008614:Meperidine; D005947:Glucose
keywords: Amino acid; Hypothermia; Pethidine; Postoperative; Shivering; Tramadol