Novamin infusion: a new method to cure postoperative shivering with hypothermia

• Published in: The Journal of surgical research Vol. 188; no. 1; pp. 69 - 76
• Main Authors: Zhou, PeiWen, MD, MS, Ge, ShengJin, MD, PhD, Wang, YaDi, RN, Xiong, WanXia, MD, PhD, Wang, TingTing, MD, MS, Xue, ZhangGang, MD, MS
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2014
• Subjects: Adult; Amino acid; Amino Acids - therapeutic use; Analgesics, Opioid - therapeutic use; Electrolytes - therapeutic use; Female; Glucose - therapeutic use; Humans; Hypothermia; Hypothermia - drug therapy; Male; Meperidine - therapeutic use; Middle Aged; Parenteral Nutrition Solutions - therapeutic use; Pethidine; Postoperative; Postoperative Complications - drug therapy; Shivering; Solutions - therapeutic use; Surgery; Tramadol; Tramadol - therapeutic use; Postoperative; Shivering; Amino acid; Pethidine; Tramadol; Hypothermia
• ISSN: 0022-4804; 1095-8673
• DOI: 10.1016/j.jss.2013.11.1117

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. Conclusion 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.