TY - JOUR
T1 - Dantrolene Reduces the Threshold and Gain for Shivering
AU - Lin, Chun Ming
AU - Neeru, Sharma
AU - Doufas, Anthony G.
AU - Liem, Edwin
AU - Shah, Yunus Muneer
AU - Wadhwa, Anupama
AU - Lenhardt, Rainer
AU - Bjorksten, Andrew
AU - Taguchi, Akiko
AU - Kabon, Barhara
AU - Sessler, Daniel I.
AU - Kurz, Andrea
PY - 2004/5
Y1 - 2004/5
N2 - Dantrolene is used for treatment of life-threatening hyperthermia, yet its thermoregulatory effects are unknown. We tested the hypothesis that dantrolene reduces the threshold (triggering core temperature) and gain (incremental increase) of shivering. Healthy volunteers were evaluated on 2 random days: control and dantrolene (≈2.5 mg/kg plus a continuous infusion). In Study 1, 9 men were warmed until sweating was provoked and then cooled until arteriovenous shunt constriction and shivering occurred. Sweating was quantified on the chest using a ventilated capsule. Absolute right middle fingertip blood flow was quantified using venous-occlusion volume plethysmography. A sustained increase in oxygen consumption identified the shivering threshold. In Study 2, 9 men were given cold lactated Ringer's solution IV to reduce core temperature ≈2°C/h. Cooling was stopped when shivering intensity no longer increased with further core cooling. The gain of shivering was the slope of oxygen consumption versus core temperature regression. In Study 1, sweating and vasoconstriction thresholds were similar on both days. In contrast, shivering threshold decreased 0.3 ± 0.3°C, P = 0.004, on the dantrolene day. In Study 2, dantrolene decreased the shivering threshold from 36.7 ± 0.2 to 36.3 ± 0.3°C, P = 0.01 and systemic gain from 353 ± 144 to 211 ± 93 mL · min -1 · °C-1, P = 0.02. Thus, dantrolene substantially decreased the gain of shivering, but produced little central thermoregulatory inhibition.
AB - Dantrolene is used for treatment of life-threatening hyperthermia, yet its thermoregulatory effects are unknown. We tested the hypothesis that dantrolene reduces the threshold (triggering core temperature) and gain (incremental increase) of shivering. Healthy volunteers were evaluated on 2 random days: control and dantrolene (≈2.5 mg/kg plus a continuous infusion). In Study 1, 9 men were warmed until sweating was provoked and then cooled until arteriovenous shunt constriction and shivering occurred. Sweating was quantified on the chest using a ventilated capsule. Absolute right middle fingertip blood flow was quantified using venous-occlusion volume plethysmography. A sustained increase in oxygen consumption identified the shivering threshold. In Study 2, 9 men were given cold lactated Ringer's solution IV to reduce core temperature ≈2°C/h. Cooling was stopped when shivering intensity no longer increased with further core cooling. The gain of shivering was the slope of oxygen consumption versus core temperature regression. In Study 1, sweating and vasoconstriction thresholds were similar on both days. In contrast, shivering threshold decreased 0.3 ± 0.3°C, P = 0.004, on the dantrolene day. In Study 2, dantrolene decreased the shivering threshold from 36.7 ± 0.2 to 36.3 ± 0.3°C, P = 0.01 and systemic gain from 353 ± 144 to 211 ± 93 mL · min -1 · °C-1, P = 0.02. Thus, dantrolene substantially decreased the gain of shivering, but produced little central thermoregulatory inhibition.
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U2 - 10.1213/01.ANE.0000108968.21212.D7
DO - 10.1213/01.ANE.0000108968.21212.D7
M3 - Article
C2 - 15105208
AN - SCOPUS:11144357133
SN - 0003-2999
VL - 98
SP - 1318
EP - 1324
JO - Anesthesia and analgesia
JF - Anesthesia and analgesia
IS - 5
ER -