Dantrolene Reduces the Threshold and Gain for Shivering

Chun Ming Lin, Sharma Neeru, Anthony G. Doufas, Edwin Liem, Yunus Muneer Shah, Anupama Wadhwa, Rainer Lenhardt, Andrew Bjorksten, Akiko Taguchi, Barhara Kabon, Daniel I. Sessler, Andrea Kurz

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1318-1324
Number of pages7
JournalAnesthesia and analgesia
Volume98
Issue number5
DOIs
StatePublished - May 2004
Externally publishedYes

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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