Influence of Preoperative Anxiety on Shivering During Elective Caesarean Section Under Spinal Anaesthesia

Study Overview
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Brief Summary
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Background Shivering occurs in circa 50 percent of cases during caesarean section under spinal anesthesia. The phenomenon's reasons and its mechanism are unclear, and while it does not endanger the patients' health, the sensations proved to be unpleasant and a subject of a number of patients' complains. Objectives The main objective of the study is to establish the anxiety factors that influence the risk of muscle-shivering and a detailed assessment of the probability of existence of the link between increased anxiety levels with the shivering in case of patients undergoing the elective caesarean section. Moreover, the outcomes of the study could help to further understand the phenomenon, reduce its occurence and as a result of that - improve the comfort of the patients in the perioperative period, as well as reduce the frequency of pharmacological treatment to halt the symptoms of muscle shivering. Methodology Patients would be asked to fill the STAI (State - Trait Anxiety Inventory) questionaire in the morning preceding the surgery. Results would be interpreted by one of the investigators, who obtained a masters degree in psychology. Caesarean section under spinal anesthesia would be performed according to standard procedures used in the Samodzielny Publiczny Szpital Kliniczny Centrum Medyczne Kształcenia Podyplomowego (SPSK CMKP) hospital, with standard non-invasive monitoring (HR, noninvasive blood pressure (NIBP), oxygen saturation (SpO2), Temperature). Additionally, the anesthesiologist would note the incidence of shivering and its precise timing 1. since the spinal block 2. since the child-birth. Moreover, patients would rate anesthesiology team influence on her anxiety level during the cesarean section in 5 grade scale - data would be collected by psychologist. The survey is planned for a one year timespan or until 200 patients have enrolled.

Conditions
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Shivering

Intervention / Treatment
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* Behavioral: STAI (State Trait Anxiety Inventory) questionaire


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: age > 18 y.o. ASA 1-2 signed informed consent form after reading the information about the study and talking with one of the investigators Exclusion Criteria: conversion to general anesthesia any severe obstetric complications, which affects obstetric or anesthesiology procedure severe bleeding language barrier anxiolytic/psychotropic drugs use

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Elective Cesarean Section<br> | Behavioral: STAI (State Trait Anxiety Inventory) questionaire<br>* Each patient would fill the STAI questionaire before Cesarean Section (on the same day, in the morning)<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Correlation between shivering and anxiety (STAI score) |  | during elective cesarean section | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Correlation between shivering and patient's temperature (noninvasive) |  | during elective cesarean section | 
| Correlation between shivering and patient's subjective assesment of anesthesiology team attitude |  | during elective cesarean section | 
| Correlation between shivering and patient's obstetric history socio-economical data. |  | during elective cesarean section | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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shivering, cesarean section, anxiety, STAI