Suppression of Shivering Decreases Oxygen Consumption and Improves Hemodynamic Stability during Postoperative Rewarming

Thirty-three patients undergoing elective myocardial revascularization were prospectively randomized into two study groups (Group S and Group P) to permit evaluation of the effects of shivering on oxygen consumption per minute (Vo₂), carbon dioxide production per minute (Vco₂), and hemodynamic performance. Group S was allowed to shiver during the postoperative rewarming period, and Group P received hourly injections of pancuronium bromide and Metubine (metocurine) sulfate with sedation to block the shivering response. Group S demonstrated significantly higher increases in Vo₂ and Vco₂, lower systolic blood pressure and mixed venous oxygen saturation, and a greater use of inotropic support than the patients in Group P. Suppression of the shivering response minimized increases in Vo₂ and Vco₂, improved hemodynamic stability, and resulted in a decreased need for inotropic support.