Post-Anaesthetic Shivering Mechanism — FRCA Final MCQ
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Correct answer: E — Combined thermoregulatory and non-thermoregulatory (post-anaesthetic tremor related to volatile agent washout)
Post-anaesthetic shivering has both thermoregulatory and non-thermoregulatory components. Thermoregulatory shivering occurs because general anaesthesia impairs the normal thermoregulatory threshold, causing peripheral vasodilation and heat redistribution from core to periphery. Approximately 40% of post-anaesthetic shivering occurs in normothermic patients, suggesting non-thermoregulatory mechanisms including: uninhibited spinal reflexes during emergence, pain, sympathetic activation, and volatile agent effects on the CNS thermoregulatory centres. This distinction is important because both components respond to pethidine/meperidine (kappa-opioid agonism).
Reference: RCOA – 2023 – Perioperative temperature management; Sessler DI – 2001 – Thermoregulation and anaesthesia