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May 13, 1988

Anesthesia Sends Shivers Up One's Spine, But Hypothermia Per Se May Not Be Culprit

JAMA. 1988;259(18):2646-2647. doi:10.1001/jama.1988.03720180002002

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WHO SHIVERS, but not from cold? Who is cold, but doesn't shiver? These riddles have puzzled anesthesiologists for years. Now, a team of investigators may have turned some of the accepted answers on their heads.

When Daniel I. Sessler, MD, was a resident in anesthesiology at the University of California, Los Angeles (UCLA), School of Medicine in the early 1980s, he proposed an explanation for why a substantial proportion of the estimated 25 million patients who undergo surgery each year are stricken with severe tremors during postoperative recovery. The shivering phenomenon, first described in 1950, sometimes dangerously boosts a patient's heart rate and blood pressure, pulls apart incisions, or damages surgical repairs. Common wisdom has it that the tremors arise because core body temperature drops during the patient's partially clothed sojourn through the cool confines of the surgical suite, inhaling cold gases and receiving cold intravenous fluids.

Sessler had a