{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T09:55:54Z","timestamp":1791453354048,"version":"4.3.3"},"reference-count":44,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"vor","delay-in-days":280,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anesthesiology Research and Practice"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Postspinal shivering is a frequent complication of spinal anesthesia (SA) and is particularly relevant in urological procedures, where perioperative heat loss can be exacerbated by irrigation fluids. Modifying the temperature of the intrathecal local anesthetic may affect thermoregulatory responses and the properties of the blockade.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This prospective, randomized, double\u2010blind, controlled trial was conducted in 96 patients (ASA I\u2013II, aged 18\u201360\u2009years) undergoing elective urological procedures under SA. Participants received intrathecal hyperbaric bupivacaine 0.5% (15\u2009mg) combined with fentanyl 25\u2009\u03bcg at one of three temperatures: 4\u00b0C (cold;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200932), 24\u00b0C (room;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200932), or 37\u00b0C (warm;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200932). Shivering was graded using the validated Crossley and Mahajan scale. The primary endpoint was the incidence of clinically significant shivering (Grade \u2265\u20093) throughout the observation period, evaluated at 10\u2010min intervals.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Cold bupivacaine demonstrated a significantly higher incidence of clinically significant shivering (Grade \u2265\u20093) (81.3%) compared with the room\u2010temperature (34.4%) and warm (25%) groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). The post hoc analysis showed that the difference between the room\u2010temperature and warm groups was not significant. Pharmacological intervention requirements were substantially elevated in the cold group (43.8%, 15.6%, 15.6%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01). Warm bupivacaine accelerated sensory and motor block onset (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001) while reducing residual motor blockade.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Warmed intrathecal bupivacaine significantly reduces PSS incidence and severity while optimizing block characteristics without compromising safety in urological patients.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial Registration:<\/jats:bold>\n                      ClinicalTrials.gov identifier: NCT07081516.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/anrp\/1005074","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T09:43:47Z","timestamp":1791452627000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of Intrathecal Bupivacaine Temperature Variation on Prophylaxis of Shivering in Urologic Patients Undergoing Spinal Anesthesia"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9702-7397","authenticated-orcid":false,"given":"Emad M.","family":"Abdelhafez","sequence":"first","affiliation":[{"name":"Anesthesia, Surgical Intensive Care, and Pain Management Department Faculty of Medicine Cairo University  Cairo Egypt  cu.edu.eg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7800-8115","authenticated-orcid":false,"given":"Hala","family":"Gomaa","sequence":"additional","affiliation":[{"name":"Anesthesia, Surgical Intensive Care, and Pain Management Department Faculty of Medicine Cairo University  Cairo Egypt  cu.edu.eg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-9954-5760","authenticated-orcid":false,"given":"Sherif M.","family":"Abdelaziz","sequence":"additional","affiliation":[{"name":"Anesthesia, Surgical Intensive Care, and Pain Management Department Memorial Institute for Ophthalmic Research  Giza Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7049-9228","authenticated-orcid":false,"given":"Esraa Sayed Ewais","family":"Muhammad","sequence":"additional","affiliation":[{"name":"Anesthesia, Surgical Intensive Care, and Pain Management Department Faculty of Medicine Cairo University  Cairo Egypt  cu.edu.eg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9875-9587","authenticated-orcid":false,"given":"Heba","family":"Bakr","sequence":"additional","affiliation":[{"name":"Anesthesia, Surgical Intensive Care, and Pain Management Department Faculty of Medicine Cairo University  Cairo Egypt  cu.edu.eg"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,8]]},"reference":[{"key":"e_1_2_12_1_2","first-page":"490","article-title":"A Comprehensive, Review of Complications Associated With Spinal Anesthesia","volume":"9","author":"Bashir A.","year":"2025","journal-title":"International Journal of Trend in Scientific Research and Development"},{"key":"e_1_2_12_2_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12871-019-0853-0"},{"key":"e_1_2_12_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajur.2018.07.001"},{"key":"e_1_2_12_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12894-021-00841-4"},{"key":"e_1_2_12_5_2","doi-asserted-by":"publisher","DOI":"10.3126\/ajms.v15i3.60133"},{"key":"e_1_2_12_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/175045890701701005"},{"key":"e_1_2_12_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2702.2010.03484.x"},{"key":"e_1_2_12_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.cd009891.pub2"},{"key":"e_1_2_12_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jopan.2023.05.002"},{"key":"e_1_2_12_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejon.2024.102717"},{"key":"e_1_2_12_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jopan.2025.05.023"},{"key":"e_1_2_12_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/md.0000000000047452"},{"key":"e_1_2_12_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2019.09.006"},{"key":"e_1_2_12_14_2","doi-asserted-by":"publisher","DOI":"10.4103\/aer.aer_86_18"},{"key":"e_1_2_12_15_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12871-018-0640-3"},{"key":"e_1_2_12_16_2","doi-asserted-by":"publisher","DOI":"10.21608\/bfsa.2024.275448.2056"},{"key":"e_1_2_12_17_2","first-page":"136","article-title":"To Compare the Efficacy of Intravenous Tramadol and Ketamine for Prevention of Shivering in Patients Undergoing Transuretheral Resection of Prostate Under Spinal Anaesthesia","volume":"15","author":"Rani A.","year":"2025","journal-title":"Journal of Cardiovascular Medicine"},{"key":"e_1_2_12_18_2","first-page":"95","article-title":"Shivering Management in Spinal Anesthesia: Evaluating the Role of Ketamine: A Narrative Review","volume":"11","author":"Sangi S.","year":"2025","journal-title":"Archives of Anesthesiology and Critical Care"},{"key":"e_1_2_12_19_2","article-title":"Efficacy of Tramadol in Preventing Postoperative Shivering: A Meta-Analysis Across Anesthesia Types and Dosages","author":"Liang J.","year":"2025","journal-title":"Asian Journal of Surgery"},{"key":"e_1_2_12_20_2","first-page":"407","article-title":"Mitigating Post-Spinal Anesthesia Shivering by Exploring Intravenous Ketamine Vs. Intravenous Tramadol and Comparison of the Optimal Dose of Ketamine: A Scoping Review of Cohort and Randomized Controlled Trials Studies","volume":"11","author":"Sangi S.","year":"2025","journal-title":"Archives of Anesthesiology and Critical Care"},{"key":"e_1_2_12_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jopan.2022.01.010"},{"key":"e_1_2_12_22_2","doi-asserted-by":"publisher","DOI":"10.21608\/bjas.2023.242669.1269"},{"key":"e_1_2_12_23_2","doi-asserted-by":"publisher","DOI":"10.4103\/aer.aer_76_19"},{"key":"e_1_2_12_24_2","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1213\/ANE.0000000000007095","article-title":"Randomized Double-Blind Study of the Effect of Injectate Temperature on Intrathecal Bupivacaine Dose Requirement in Spinal Anesthesia for Cesarean Delivery","volume":"140","author":"Zhao Y. P.","year":"2025","journal-title":"Anesthesia & Analgesia"},{"key":"e_1_2_12_25_2","doi-asserted-by":"publisher","DOI":"10.1097\/eja.0000000000000880"},{"key":"e_1_2_12_26_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00540-021-02995-9"},{"key":"e_1_2_12_27_2","doi-asserted-by":"publisher","DOI":"10.14260\/jemds\/2021\/94"},{"key":"e_1_2_12_28_2","doi-asserted-by":"publisher","DOI":"10.4103\/1658-354x.105854"},{"key":"e_1_2_12_29_2","first-page":"53","article-title":"Cold and Touch Stimulation for the Assessment of Block Level at Spinal Anesthesia","volume":"12","author":"Be\u015fta\u015f A.","year":"2007","journal-title":"F\u0131rat T\u0131p Dergisi"},{"key":"e_1_2_12_30_2","doi-asserted-by":"publisher","DOI":"10.5505\/kjms.2013.76476"},{"key":"e_1_2_12_31_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12630-023-02552-w"},{"key":"e_1_2_12_32_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.1994.tb03422.x"},{"key":"e_1_2_12_33_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12871-025-03517-w"},{"key":"e_1_2_12_34_2","first-page":"GC07","article-title":"A Randomised Trial Comparing Efficacy, Onset and Duration of Action of Pethidine and Tramadol in Abolition of Shivering in the Intra Operative Period","volume":"8","author":"Mahesh T.","year":"2014","journal-title":"Journal of Clinical and Diagnostic Research"},{"key":"e_1_2_12_35_2","first-page":"394","article-title":"Validity and Reliability of Visual Analogue Scale (VAS) for Pain Measurement","volume":"2","author":"Begum M. R.","year":"2019","journal-title":"Journal of Medical Case Reports and Reviews"},{"key":"e_1_2_12_36_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.1986.tb02480.x"},{"key":"e_1_2_12_37_2","doi-asserted-by":"publisher","DOI":"10.53766\/acbio\/2023.14.27.03"},{"key":"e_1_2_12_38_2","doi-asserted-by":"publisher","DOI":"10.1213\/01.ane.0000184252.16045.0e"},{"key":"e_1_2_12_39_2","doi-asserted-by":"publisher","DOI":"10.4103\/ijpn.ijpn_42_19"},{"key":"e_1_2_12_40_2","article-title":"Effect of Intrathecal Bupivacaine Kept at Room Temperature Versus Body Temperature on Shivering During Lower Limb Orthopaedic Surgery Under Spinal Anaesthesia: A Double-Blind Randomised Controlled Trial","volume":"19","author":"Kumar A.","year":"2025","journal-title":"Journal of Clinical and Diagnostic Research"},{"key":"e_1_2_12_41_2","first-page":"UC18","article-title":"In Spinal Anaesthesia for Cesarean Section the Temperature of Bupivacaine Affects the Onset of Shivering But Not the Incidence: A Randomized Control Trial","volume":"10","author":"Kishore N.","year":"2016","journal-title":"Journal of Clinical and Diagnostic Research"},{"key":"e_1_2_12_42_2","doi-asserted-by":"publisher","DOI":"10.4103\/joacp.joacp_156_21"},{"key":"e_1_2_12_43_2","doi-asserted-by":"publisher","DOI":"10.1213\/00000539-200004000-00030"},{"key":"e_1_2_12_44_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-019-52960-6"}],"container-title":["Anesthesiology Research and Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/anrp\/1005074","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/anrp\/1005074","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/anrp\/1005074","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T09:43:49Z","timestamp":1791452629000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/anrp\/1005074"}},"subtitle":[],"editor":[{"given":"Chao","family":"Meng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":44,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/anrp\/1005074"],"URL":"https:\/\/doi.org\/10.1155\/anrp\/1005074","archive":["Portico"],"relation":{},"ISSN":["1687-6962","1687-6970"],"issn-type":[{"value":"1687-6962","type":"print"},{"value":"1687-6970","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2026-06-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"1005074"}}