The effects of warm and cold intrathecal bupivacaine on shivering during delivery under spinal anesthesia

Background: Shivering associated with neuraxial anesthesia is a common problem that is uncomfortable for patients; it is of unknown ethnology and has no definite treatment. Purpose: The purpose of this study was to compare the effects of warm intrathecal bupivacaine stored at 23 degrees C and cold intrathecal bupivacaine stored at 4 degrees C on shivering during delivery under spinal anesthesia. Methods: Seventy-eight parturient women scheduled for nonemergency cesarean delivery were enrolled in the study and separated into 2 groups. The standard group received 10 mg of heavy bupivacaine 0.5% stored at room temperature (23 degrees C) plus 10 mu g of fentanyl intrathecally (warm group), and the case group received 10 mg of heavy bupivacaine 0.5% stored at 4 degrees C plus 10 mu g of fentanyl intrathecally (cold group). Data collection, including sensory block level, blood pressure, core temperature, and shivering intensity, was first performed every minute for 10 min, then every 5 min for 35 min and, finally, every 10 min until the sensory level receded to L4. Results: There were no differences between the 2 groups in the amount of bleeding, pulse rate, oxygen saturation, neonatal Apgar, and incidence of vomiting. The incidence and intensity of shivering decreased in the warm group (P=0.002). Conclusion: Warming of solutions can reduce the incidence and intensity of shivering in parturient candidates for cesarean delivery under spinal anesthesia.