• Kerstin D Röhm, Jörn Riechmann, Joachim Boldt, Stefan W Suttner, and Swen N Piper.
• Department of Anesthesiology and Critical Care Medicine, Klinikum Ludwigshafen, Ludwigshafen, Germany.
• Med. Sci. Monit. 2006 Nov 1;12(11):CR452-6.

BackgroundPostanesthetic shivering (PAS) is a frequent side effect of general anesthesia. Previous reports on the incidence of PAS of propofol for the induction or maintenance of anesthesia have been controversial, but have not been studied in detail. The aim of the present study was to evaluate the incidence and severity of PAS in total intravenous anesthesia (TIVA) with propofol and remifentanil compared with an inhalative anesthesia.Material/MethodsAfter ethics committee approval and written informed consent from the patients, 53 patients scheduled for urologic, gynecologic, or surgical operations were studied for shivering postoperatively using a five-point rating scale. They received desflurane-fentanyl based anesthesia (n=27) or TIVA with propofol and remifentanil (n=26). Hemodynamics and temperature were measured after induction of anesthesia (T0), and 5 min (T1), 15 min (T2), 30 min (T3), and 60 min (T4) after reaching the postanesthetic care unit (PACU).ResultsIn the TIVA group, 18/26 (69.2%) patients suffered from PAS compared with 10/27 (37%) in the desflurane-fentanyl group (P<0.02). The severity of shivering was significantly higher with TIVA than with desflurane (P<0.02), whereas temperature showed no significant difference between the study groups.ConclusionsPostanesthetic shivering appears significantly more frequently and intensively after TIVA with propofol and remifentanil compared with an inhalative anesthesia with fentanyl and desflurane.

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