PMID: 9447863Feb 3, 1998Paper

Physostigmine prevents postanesthetic shivering as does meperidine or clonidine

Anesthesiology
E P HornJ Schulte am Esch

Abstract

Postanesthetic shivering develops in as many as one half of patients recovering from isoflurane anesthesia. Cholinergic stimulation of the hypothalamic-pituitary-adrenal axis and adrenal medulla by physostigmine enhances secretion of arginine vasopressin, epinephrine, and norepinephrine. Because the hypothalamus is the dominant thermoregulatory controller in mammals, and these neurotransmitters may be involved in body temperature control, physostigmine administration may influence the incidence of shivering. Accordingly, the authors tested the hypothesis that physostigmine administration inhibits postanesthetic shivering. Its efficacy was compared with that of saline (negative control) and meperidine and clonidine (positive controls). Sixty patients having surgery of the ear or nose were tested. General anesthesia was induced with 2 mg/kg propofol, 0.1 mg/kg vecuronium, and 1.5 microg/kg fentanyl and maintained with isoflurane (1.5 +/- 0.4%) in 70% nitrous oxide. At the end of surgery, the patients were randomly assigned to receive an intravenous bolus of 0.04 mg/kg physostigmine, isotonic saline, 0.5 mg/kg meperidine, or 1.5 microg/kg clonidine. Heart rate, mean arterial blood pressure, oxygen saturation, visual analog pain sc...Continue Reading

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Citations

Aug 12, 1999·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·C R Ries
Dec 10, 2003·Best Practice & Research. Clinical Anaesthesiology·Kate Leslie, Daniel I Sessler
Jun 24, 2011·International Anesthesiology Clinics·Brian A Williams, Michael L Kentor
Dec 24, 2004·Anesthesia and Analgesia·Andrea ParisPeter H Tonner
May 15, 2009·Anesthesia and Analgesia·Taishi MasamuneTakashi Matsukawa
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Jan 18, 2016·Lancet·Daniel I Sessler
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Aug 29, 2001·Anesthesia and Analgesia·R GreifD I Sessler

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