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Incidence of postoperative shivering decreased with the use of acetaminophen: a propensity score matching analysis

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Abstract

Objectives

The incidence of postoperative shivering is known to be inversely associated with core body temperature. However, previous studies have pointed out that the threshold of shivering could be affected by peripheral temperature or anesthetic agents. These reports pointed specific drugs, though, anesthesia techniques have since advanced considerably. This study aimed to investigate factors associated with postoperative shivering in the context of the current body warming practice.

Methods

The institutional clinical research ethics committee of Kyushu University approved the study protocol (IRB Clinical Research number 2019-233). This retrospective study involved 340 patients who had undergone radical surgery for gynecological cancer treatment under general anesthesia at our center from December 2012 to June 2019. Logistic regression analysis was performed to estimate the odds ratio (OR) for the incidence of postoperative shivering.

Results

Postoperative shivering developed in 109 out of 340 patients. After multivariate-adjusted logistic regression, the incidences of postoperative shivering decreased significantly with increasing patient age (OR = 0.96; 95%CI: 0.93–0.98; p = 0.0004). Volatile anesthesia technique was less inclined to shiver after surgery than TIVA (OR = 0.55; 95%CI: 0.30–0.99; p = 0.04). Acetaminophen was much less used in the shivering group than in the non-shivering group (OR = 0.49; 95%CI: 0.25–0.94; p = 0.03).

Conclusions

This study indicated that the development of shivering in patients receiving the anesthetic technique currently used in our hospital was associated with use of acetaminophen or volatile agents, and patient age.

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Authors and Affiliations

  1. Department of Anesthesiology and Critical Care Medicine, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Kazuhiro Shirozu & Yutaro Kammura

  2. Operating Rooms, Kyushu University Hospital, Fukuoka, Japan

    Kaoru Umehara

  3. Department of Anesthesiology, Hamanomachi Hospital, Fukuoka, Japan

    Mizuko Ikeda

  4. Department of Anesthesiology and Critical Care Medicine, Kyushu University Graduate School of Medicine, Fukuoka, Japan

    Ken Yamaura

Authors
  1. Kazuhiro Shirozu
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  2. Kaoru Umehara
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  3. Mizuko Ikeda
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  4. Yutaro Kammura
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  5. Ken Yamaura
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Contributions

New author “KU” performed multiple analysis and propensity score matching analysis in this revised version. This propensity analysis was absolutely needed due to reviewer’s comments and all original authors could not perform it.

Corresponding author

Correspondence to Kazuhiro Shirozu.

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Conflict of interest

The authors declare that they have no conflict of interest.

IRB

Faculty of Medical sciences, Kyushu University Institutional Review Board Clinical Research number #2019-233

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Shirozu, K., Umehara, K., Ikeda, M. et al. Incidence of postoperative shivering decreased with the use of acetaminophen: a propensity score matching analysis. J Anesth 34, 383–389 (2020). https://doi.org/10.1007/s00540-020-02763-1

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  • DOI: https://doi.org/10.1007/s00540-020-02763-1

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