Postoperative temperature is higher in patients developing post-anesthesia shaking than in those not developing shaking

2.50
Hdl Handle:
http://hdl.handle.net/10755/150719
Type:
Presentation
Title:
Postoperative temperature is higher in patients developing post-anesthesia shaking than in those not developing shaking
Abstract:
Postoperative temperature is higher in patients developing post-anesthesia shaking than in those not developing shaking
Conference Sponsor:Sigma Theta Tau International
Conference Year:1992
Conference Date:May 19 - 22, 1992
Author:Vogelsang, Joan, EdD
P.I. Institution Name:University Hospital Pacu
Title:Clinical Nurse
While the etiology of postanesthesia shaking (PS) remains unknown,

nurses traditionally believe hypothermia is the cause. There are

two theoretical constructs describing PS. The first is based on

classic thermoregulation adaptive responses to a loss in body

temperature. The second, spinal reflex hyperactivity, postulates

that shaking occurs secondary to loss of cortical inhibition when

an anesthetic end-tidal concentration causes inhibition of

supraspinal modulation pathways. The purpose of this comparison

study is to determine whether there is a difference in

postoperative, and in pre to postoperative temperature loss in

patients developing or not developing PS. The study also examines

whether there is a within group difference in postoperative

temperature between women and men.



The nonprobability convenience sample consists of two groups of

patients between the ages of 18 and 89 years (x=44) undergoing

general anesthesia who are extubated and breathing spontaneously on

admission to the Post Anesthesia Care Unit (PACU). On PACU

admission, postoperative axillary temperature is measured.

Patients are observed for shaking development on admission and

every 5 minutes for 60 minutes. PS develops in 120 of 533 patients

reaching grade 2 or 3 on a 0 to 3 visual scale (none, weak, strong,

or forceful). Temperature range for the group developing PS is

narrower and higher 33.l-37.5C/9l.7-99.5F (x=34.9C/94.9F). The

group not developing PS has a wider and lower range of temperature

31.7-37.1C/89.1-98.8F (x=34.8C/94.7F). Preoperative temperature

obtained from patient records is converted to an axillary

reference. Pre to postoperative temperature loss ranges from 0.0-

4.3C/0.0-7.8F (x=l.8C/3.3F) for the group developing PS. Those not

developing PS exhibit a greater pre to postoperative loss ranging

from 0.4-5.8C/0.7-l0.4F (x=l.9C/3.4F). By t-test analysis, there

is no statistically significant difference in postoperative mean

temperature, P>.10, or in pre to postoperative mean temperature

loss, P>.40. For both groups, 52 percent of the patients are

hypothermic on PACU admission, <35C/95F. Women have significantly

lower postoperative mean temperature than men, P<.05. Findings

indicate that temperature upon PACU admission is not a variable of

difference between groups of patients developing or not developing

PS. This supports the theoretical construct postulating that PS is

a spinal reflex hyperactivity augmented by inhibition of

supraspinal modulation pathways rather than a thermoregulatory

response mechanism. Suggestions for further research focus on

differentiating between hypothermia and PS in order to initiate

effective nursing intervention for each condition.



Repository Posting Date:
26-Oct-2011
Date of Publication:
19-May-1992
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titlePostoperative temperature is higher in patients developing post-anesthesia shaking than in those not developing shakingen_GB
dc.identifier.urihttp://hdl.handle.net/10755/150719-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Postoperative temperature is higher in patients developing post-anesthesia shaking than in those not developing shaking</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">1992</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">May 19 - 22, 1992</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Vogelsang, Joan, EdD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University Hospital Pacu</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Clinical Nurse</td></tr><tr><td colspan="2" class="item-abstract">While the etiology of postanesthesia shaking (PS) remains unknown,<br/><br/>nurses traditionally believe hypothermia is the cause. There are<br/><br/>two theoretical constructs describing PS. The first is based on<br/><br/>classic thermoregulation adaptive responses to a loss in body<br/><br/>temperature. The second, spinal reflex hyperactivity, postulates<br/><br/>that shaking occurs secondary to loss of cortical inhibition when<br/><br/>an anesthetic end-tidal concentration causes inhibition of<br/><br/>supraspinal modulation pathways. The purpose of this comparison<br/><br/>study is to determine whether there is a difference in<br/><br/>postoperative, and in pre to postoperative temperature loss in<br/><br/>patients developing or not developing PS. The study also examines<br/><br/>whether there is a within group difference in postoperative<br/><br/>temperature between women and men.<br/><br/><br/><br/>The nonprobability convenience sample consists of two groups of<br/><br/>patients between the ages of 18 and 89 years (x=44) undergoing<br/><br/>general anesthesia who are extubated and breathing spontaneously on<br/><br/>admission to the Post Anesthesia Care Unit (PACU). On PACU<br/><br/>admission, postoperative axillary temperature is measured.<br/><br/>Patients are observed for shaking development on admission and<br/><br/>every 5 minutes for 60 minutes. PS develops in 120 of 533 patients<br/><br/>reaching grade 2 or 3 on a 0 to 3 visual scale (none, weak, strong,<br/><br/>or forceful). Temperature range for the group developing PS is<br/><br/>narrower and higher 33.l-37.5C/9l.7-99.5F (x=34.9C/94.9F). The<br/><br/>group not developing PS has a wider and lower range of temperature<br/><br/>31.7-37.1C/89.1-98.8F (x=34.8C/94.7F). Preoperative temperature<br/><br/>obtained from patient records is converted to an axillary<br/><br/>reference. Pre to postoperative temperature loss ranges from 0.0-<br/><br/>4.3C/0.0-7.8F (x=l.8C/3.3F) for the group developing PS. Those not<br/><br/>developing PS exhibit a greater pre to postoperative loss ranging<br/><br/>from 0.4-5.8C/0.7-l0.4F (x=l.9C/3.4F). By t-test analysis, there<br/><br/>is no statistically significant difference in postoperative mean<br/><br/>temperature, P&gt;.10, or in pre to postoperative mean temperature<br/><br/>loss, P&gt;.40. For both groups, 52 percent of the patients are<br/><br/>hypothermic on PACU admission, &lt;35C/95F. Women have significantly<br/><br/>lower postoperative mean temperature than men, P&lt;.05. Findings<br/><br/>indicate that temperature upon PACU admission is not a variable of<br/><br/>difference between groups of patients developing or not developing<br/><br/>PS. This supports the theoretical construct postulating that PS is<br/><br/>a spinal reflex hyperactivity augmented by inhibition of<br/><br/>supraspinal modulation pathways rather than a thermoregulatory<br/><br/>response mechanism. Suggestions for further research focus on<br/><br/>differentiating between hypothermia and PS in order to initiate<br/><br/>effective nursing intervention for each condition.<br/><br/><br/><br/></td></tr></table>en_GB
dc.date.available2011-10-26T10:40:59Z-
dc.date.issued1992-05-19en_GB
dc.date.accessioned2011-10-26T10:40:59Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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