title: The effects of warmed intravenous fluids, combined warming (warmed intravenous fluids with humid-warm oxygen), and pethidine on the severity of shivering in general anesthesia patients in the recovery room.
abstract: BACKGROUND
  Shivering is a common complication of general and epidural anesthesia. Warming methods and many drugs are used for control of shivering in the recovery room. The present study is a randomized clinical trial aimed to investigate the effects of two interventions in comparison with pethidine which is the routine treatment on shivering in patients undergoing abdominal surgery with general anesthesia.
  
  
  METHODS
  Eighty-seven patients undergoing abdominal surgery by general anesthesia were randomly assigned to three groups (two intervention groups in comparison with pethidine as routine). Patients in warmed intravenous fluids group received pre-warmed Ringer serum (38°C), patients in combined warming group received pre-warmed Ringer serum (38°C) accompanied by humid-warm oxygen, and patients in pethidine group received intravenous pethidine routinely. The elapsed time of shivering and some hemodynamic parameters of the participants were assessed for 20 min postoperatively in the recovery room. Then the collected data were analyzed by software SPSS (v. 16) with the significance level being P < 0.05.
  
  
  RESULTS
  The mean of elapsed time in the warmed intravenous serum group, the combined warming group, and the pethidine group were 7 (1.5) min, 6 (1.5) min, and 2.8 (0.7) min, respectively, which was statistically significant (P < 0.05). The body temperatures in both combined warming and pethidine groups were increased significantly (P < 0.05).
  
  
  CONCLUSIONS
  Combined warming can be effective in controlling postoperative shivering and body temperature increase.
authors.affiliation: Assistant Professor, Birjand Health Qualtative Research Center, Birjand University of Medical Science, Birjand, Iran.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Nasiri
authors.affiliation: MSc. Student, School of Nursing and Midwifery, Birjand University of Medical Sciences, Birjand, Iran.
authors.forename: Ayob
authors.initials: A
authors.lastname: Akbari
authors.affiliation: Assistant Professor, Social Determinant of Health Research Center, Birjand University of Medical Science, Birjand, Iran.
authors.forename: GholamReza
authors.initials: G
authors.lastname: Sharifzade
authors.affiliation: Assistant Professor of Anesthesiology, Birjand University of Medical Science, Birjand, Iran.
authors.forename: Pooya
authors.initials: P
authors.lastname: Derakhshan
keywords: General anesthesia; humid-warm oxygen inhalation; pethidine; postoperative shivering; shivering; warmed intravenous fluids