Anaesthetic temperature and shivering in epidural anaesthesia

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Abstract
The mechanism of shivering during epidural analgesia remains unclear. This study investigates the role of the temperature of the local anesthetic injected extradurally. Forty patients admitted for elective cesarean section under epidural anesthesia were studied; 20 were given bupivacaine warmed to 37.degree. C (warm group) and 20 were given bupivacaine stored at 4.degree. C (cold group); the occurrence of shivering in both groups was recorded. The overall incidence of shivering was 27.5%; two patients of the warm group and nine patients of the cold group shivered. This difference was statistically significant (P < 0.03). The result suggest that there are thermosensory mechanisms in the human spinal canal. In our view, epidural anesthetic solutions should be warmed to body temperature prior to injection to reduce the incidence of shivering.

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