kenwishaw

In most cases shivering after epidurals is caused by redistribution hypothermia. The epidural dramatically increases blood flow to the legs and if the legs are even a few degrees cooler then the core the blood will return cooled and cause a drop in core temperature. This cannot be detected with a thermometer prior to the epidural but can be detected by putting your hand on the patients calf muscle. The incidence of shivering is dramatically decreased by prewarming the legs prior to the epidural. A small percentage of patients will shiver in spite of this and Pethidine (demerol) 12.5 mg may help. Ken, anaesthesiologist.