title: Prevalence, associated factors and treatment of post spinal shivering in a Sub-Saharan tertiary hospital: a prospective observational study.
abstract: Surgery and anaesthesia cause shivering due to thermal dysregulation as a compensatory mechanism and is worsened by vasodilatation from spinal anaesthesia that redistributes core body heat. Due to paucity of data Mulago Hospital's post spinal shivering burden is unknown yet it causes discomfort and morbidity.
  
  
  
  Ethical approval was obtained to perform the study among consenting mothers due for elective caesarean section from March to May 2011. We recruited ASA class I & II parturients and excluded non-consenting or spinal contra-indication patients. A standard spinal anaesthetic of 2mls of 0.5 % bupivacaine was given, intraoperative vitals were recorded every 5 min and we monitored for perioperative shivering till PACU discharge.
  
  
  
  We recruited 270 patients with majority being emergency caesarean deliveries (90.74 %), mainly due to failed progress from cephalopelvic disproportion. We noted 8.15 % shivering occuring mostly at 20 min, with hypotension plus hypothermia as associated factors. Intravenous pethidine (Meperidine) 25 mg effectively treated shivering and we had drowsiness, nausea and vomiting as PACU side effects that resolved on discharge to the ward.
  
  
  
  Post spinal shivering had a prevalence of 8.15 %, commonly occurred at 20 min postoperatively with hypotension plus hypothermia as main associated factors and intravenous Pethidine controlled it.
authors.affiliation: Department of Anaesthesia, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda. tluggya@gmail.com.
authors.forename: Tonny Stone
authors.initials: TS
authors.lastname: Luggya
authors.affiliation: Directorate of Surgery, Mulago National Referral Hospital, Kampala, Uganda.
authors.forename: Richard Nicholas
authors.initials: RN
authors.lastname: Kabuye
authors.affiliation: Directorate of Surgery, Mulago National Referral Hospital, Kampala, Uganda.
authors.forename: Cephas
authors.initials: C
authors.lastname: Mijumbi
authors.affiliation: Department of Anaesthesia, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
authors.forename: Joseph Bahe
authors.initials: JB
authors.lastname: Tindimwebwa
authors.affiliation: Department of Anaesthesia, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
authors.forename: Andrew
authors.initials: A
authors.lastname: Kintu
mesh_terms: D000759:Adjuvants, Anesthesia / Q000008:administration & dosage; D000328:Adult; D017954:Africa South of the Sahara; D000773:Anesthesia, Obstetrical / Q000009:adverse effects / Q000379:methods*; D000775:Anesthesia, Spinal / Q000009:adverse effects / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage; D002045:Bupivacaine / Q000008:administration & dosage; D002585:Cesarean Section / Q000379:methods*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007022:Hypotension / Q000453:epidemiology; D007035:Hypothermia / Q000453:epidemiology; D008614:Meperidine / Q000008:administration & dosage; D011247:Pregnancy; D015995:Prevalence; D011446:Prospective Studies; D012768:Shivering; D062606:Tertiary Care Centers
chemical_list: D000759:Adjuvants, Anesthesia; D000779:Anesthetics, Local; D008614:Meperidine; D002045:Bupivacaine
keywords: Caesarean section; Pethidine (meperidine); Post spinal shivering; Spinal anaesthesia