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Post-Anaesthetic Shaking, A Review of the Literature
Reena Wallis, RCompN. At the time of writing this paper, Reena Wallis was Acting Charge Nurse, Recovery Room, Palmerston North Hospital
Reference: Wallis, R. (2000). Post-Anaesthetic Shaking, A Review of the Literature Nursing Praxis in New Zealand 15(1) 23-32
This paper describes the phenomenon of post-anaesthetic shaking (PAS) as it is discussed in the literature. Literature was obtained via computerised searches of the Cochrant Library, Medline, and Cumulative Index of Nursing and Allied Health Literature (CINAHL) databases. This review considers PAS in adults, who have had either a general or regional anaesthetic. It focuses on the controversy regarding the cause of the condition, the role of anaesthetics in hypothermia, pharmacological interventions, and non-pharmacological interventions. The key conclusion to emerge is that nurses must take patients’ shaking seriously and initiate treatment for it. If PAS is associated with hypothermia then the patient needs to be rewarmed, and if it is associated with pain, analgesia needs to be administered.
Key Words: Post-anaesthetic shaking, shivering, hypothermia
Shaking after regional or general anaesthetics is a complication of anaesthesia familiar to Post Anaesthetic Care Unit (PACU) nurses. This paper addresses the problem of shaking and shivering as it is discussed in the nursing and medical literature. It was noted that the problem is poorly understood, shaking frequently being referred to as shivering. Yet not all patients who shiver feel cold, and not all patients who are cold shiver. In the following pages post-anaesthetic shaking (PAS) will be defined and the incidence detailed, and the various causes and consequences proposed in the literature will also be discussed. Ways of preventing and treating PAS that are pertinent to nurses will be examined.