Saturday, October 22, 2005

Saturday October 22, 2005
Hypothermic Shivering

As induction of hypothermia is gaining more ground in our ICUs for acute stroke patients - associated shivering remains a major issue. One trick of the trade is to add oral Buspirone (15-60 mg in 2-3 divided doses) with traditional IV Meperidine. The combination of buspirone and meperidine has been found to act synergistically to reduce the shivering (and dose of meperidine) while causing little sedation or respiratory toxicity.

(Re-warming should be slow and controlled to avoid complications.
For rewarming tips see related MGH's Hypothermia Protocol after Cardiac Arrest in our protocol section).

References: Click to get abstract
Buspirone and Meperidine Synergistically Reduce the Shivering Threshold - Anesth Analg 2001;93:1233-1239
Controlled trials of hypothermia in stroke -