Reducing Incidence of Shivering by Wrapped Equipment in Cesarean Section UnderSpinal Anesthesia, Nakhonphanom Hospital

Abstract

Background: Shivering from hypothermia cause is a common incident in cesarean section patient under spinal anesthesia. It can drive oxygen tissue demand raise to six fold of normothermia,that affect to induce the incident of myocardial ischemia from cardiovascular complication. Beyond the ordinary care pattern had been wrapped undergo patient with only surgical sheet. The shivering incident was found in 31.1% per month.

Objectives: The main purpose was to study the incident of shivering in maternal cesarean section under spinal anesthesia that compare between use and unused wrapped equipment.

Materials and Method: The efficacy prospective randomized control trial study was implement between December 2016 and May 2017 in operating department at Nakhon Phanom hospital. The undergo maternal cesarean section under spinal anesthesia had 97 cases in controlled group and equal to trialed group with wrapped equipment in 97 cases. After the participants had consented the researcher could randomization in each treatment group. Both of groups were repeated measures temperature in 4 periods including pre-operative, intra-operative, post-operative in operating room, and post-operative in recovery room. The degree of shivering was observed in 4 level. The inferential statistic used the exact probability test, t-test for analyzed result of shivering. The confound factor was adjusted   with multivariable ordinal logistic regression.

Results: The results illustrated that the wrapped equipment had efficacy to reduce incident of shivering patient undergo cesarean section with spinal anesthesia in 7.1%. There were statistically significant difference at p-value <0.001.

Conclusion: The wrapped equipment can prevent heat loss mechanism and reduce incident of shivering in undergo cesarean section with spinal anesthesia. That is the evidence base for improving practice guideline of patient undergoes cesarean section with spinal anesthesia.