Pethidine and skin warming to prevent shivering during endovascular cooling

Abstract

We tested the efficacy of pethidine and cutaneous warming to prevent shivering during percutaneous cooling in unanaesthetized patients. Ten patients scheduled for cranial neurosurgery received pethidine infusion and skin warming. The Setpoint™ internal heat-exchanging catheter was inserted and cooling to 33.5°C was started. Clonidine and chlorpromazine were given as "rescue medication" to treat shivering. General anaesthesia was planned to be induced after cooling was complete. Rewarming was initiated at dural closure. Three patients successfully completed the protocol, cooling to 33.8°C at a median rate of 3.6 (range: 3.4-3.8) °C/h. Two patients cooled to 33.8°C but required treatment for s..