http://e-journal.unair.ac.id/JNERS | 305 Jurnal Ners Vol. 14, No. 3, Special Issue 2019 http://dx.doi.org/10.20473/jn.v14i3.17166 This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License Original Research Management of Shivering in Post-Spinal Anesthesia Using Warming Blankets and Warm Fluid Therapy Arina Qona’ah 1 ,Novi Enis Rosuliana 2 , I Made Amartha Bratasena 2 , and Wahyu Cahyono 2 1 Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia 2 Sekolah Tinggi Ilmu Kesehatan Mataram, Mataram, Indonesia ABSTRACT Introduction: Hypothermia is a common and serious complication of spinal surgery and it is associated with many harmful perioperative outcomes. The aim of this study was to compare the effectiveness of warming blankets and warm fluid therapy to manage shivering. Methods: A quasi-experiment with a non-equivalent control group was applied as the research design. There were 60 patients involved in the study. The instrument of this study was a warmer fluid modification, a warming blanket and a cotton blanket. The data was analyzed using an applied paired t-test and independent t-test. Results: After 60 minutes of the intervention, the mean and SD of body temperature of the patients receiving warm fluids was 36.71 ± 0.18, a warming blanket was 36.12 ± 0.35, and the control group was 35.76 ± 0.22. The p values were 0,000. Conclusion: Warm fluid therapy and warming blankets are significant in terms of increasing the body temperature of post-spinal anesthesia patients. Warm fluids are more effective than warming blanket. Warming blankets and warm fluid therapy can be used as a way to increase the body temperature of patients with hypothermia. ARTICLE HISTORY Received: Dec 26, 2019 Accepted: Dec 31, 2019 KEYWORDS Warm fluid therapy; warming blankets; hypothermia CONTACT Arina Qona’ah  arina-qonaah@fkp.unair.ac.id  Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia Cite this as: Qona’ah, A.., Rosuliana, N.E., Bratasena, I.M.A & Cahyono, W. (2019). Management of Shivering in Post-Spinal Anesthesia Using Warming Blankets and Warm Fluid Therapy. Jurnal Ners, Special Issues, 305-309. doi:http://dx.doi.org/10.20473/jn.v14i3.17166 INTRODUCTION Hypothermia often occurs in postoperative patients. Around 40-60 minutes after anesthesia, the body temperature decreases intensively(Moysés, Trettene, Navarro, & Ayres, 2014). Hypothermia occurs when the body temperature is less than 36 0 C at the perioperative point in time and during anesthesia. Hypothermia is caused by a cold operating room, decreased metabolism, the length and type of operation, body cavity exposure, the type of anesthesia and the fluids used in the operative processes(De Figueiredo Locks, 2012). Based on the results of a survey conducted on 564 patients, 45.7% experienced hypothermia(Aksu, Kus, Gurkan, Solak, & Toker, 2014). Harahap (2014) said that the number of patients who experienced hypothermia in the recovery room was 113 people (87.6%). In the patients receiving spinal anesthesia, the incidence rate of hypothermia was higher than that for general anesthesia (52%)(Shaw, Steelman, DeBerg, & Schweizer, 2017). Hypothermia is an independent factor in the occurrence of death due to interference various organs of the body and produce shivering in the post-operative period(Harahap, Kadarsah, & Oktaliansah, 2014)(Okeke, 2007). Hypothermia triggers shivering where oxygen demand increases 500%(Zaman, Rahmani, Majedi, Roshani, & Valiee, 2018). Shivering is the body's protection mechanism by increasing heat production through muscle contractions. Muscle contractions can increase heat production, oxygen consumption, and carbon dioxide production. This can lead to a risk of complications in patients with cardiovascular and pulmonary disorders(De Figueiredo Locks, 2012). Shivering occurs in 50% of operating patients with a body temperature of 35.5 0 C and 90% in patients with a body temperature of 34.5 0 C (Harahap et al., 2014). Shivering is more common in surgical patients who