Relationship between Core-Peripheral Temperature Difference and Shivering Symptom in Patients in Post-Anesthesia Care Unit
Phuriphong Songarj MD*, Pairin Simcharoen MD*, Mingkwan Wongyingsinn MD, MSc*
Affiliation : * Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Objective : To investigate the relationship between shivering symptom and core-peripheral temperature differences of
postoperative patients admitted to post-anesthesia care unit (PACU) and evaluate factors related to postoperative shivering.
Material and Method: This is a prospective case control study which observed postoperative adult patient, ASA physical
class I-III with the operative period of 1 to 4 hours who were admitted to PACU. Core (tympanic membrane) and peripheral
(forehead and dorsum of hand) temperature was measured at 0, 15, 30, 45 and 60 minutes PACU admission. Shivering
symptom was observed at the same time points of temperature measurement and classified by severity of shivering into grade
0 to 4.
Results : Patients with shivering had significantly less core-forehead temperature differences compared with patients without
shivering but the core-dorsum of hand temperature differences were similar in both groups. In one hundred patients in the
shivering group, 90% of the patients had shivering when immediately admitted to PACU and there were only 26% of patients
having the symptom at 60 minutes. Factors related to shivering symptom were vascular surgery (adjusted OR 16.40 (95%
CI 1.37 to 195.68), p = 0.03) and abdominal surgery (adjusted OR 4.38 (95% CI 1.06 to 18.09), p = 0.04).
Conclusion : The core-forehead temperature difference was related with shivering symptom in PACU while the core-dorsum
of hand difference has no relationship. Types of surgery including vascular surgery and abdominal surgery were identified as
factors related to shivering symptom.
Keywords : Shivering, Temperature Differences, Post-anesthetic care unit
