Effectiveness of dexmedetomidine use in general anesthesia to prevent postoperative shivering: a systematic review protocol.

Abstract

Review question/objective The following question guides the systematic review: In adult patients undergoing general anesthesia, what is the effectiveness of dexmedetomidine, compared to placebo, in preventing shivering in the first two hours after surgery? The objective of this systematic review is to synthesize the best available evidence on the efficacy of dexmedetomidine in preventing the occurrence of postanesthetic shivering. Inclusion Criteria Types of participants This review will consider studies that include adult patients between 18 and 70 years of age receiving general anesthesia for any surgical procedure in any clinical setting. Only studies examining patients with American Society of Anesthesiologist physical status 1 or 2 will be considered. Studies including anesthetic techniques other than general anesthesia will be excluded. Studies including patients less than 18 years of age will also be excluded, as the incidence of postanesthetic shivering in this population is low and the risk to benefit ratio doesn’t warrant prophylactic treatment. Type of intervention This review will evaluate the effectiveness of dexmedetomidine in preventing postanesthetic shivering. Studies that compare preoperative or intraoperative administration of dexmedetomidine to placebo will be considered. Only intravenous administration techniques of dexmedetomidine will be included. Studies to be examined will include dexmedetomidine administration times of 30 minutes prior to induction of general anesthesia and any other intraoperative administration times. Dexmedetomidine boluses and infusions will be completed prior to patient arrival to post-anesthesia care unit. Studies will be excluded if the dexmedetomidine is administered during post-anesthesia care unit stay. Examined studies will include the administration of dexmedetomidine as a one-time bolus, continuous infusion, or a combination of bolus and infusion doses. Only studies evaluating dexmedetomidine as the sole pharmacological agent in the prevention of postanesthetic shivering will be considered. Studies evaluating dexmedetomidine for the treatment of postanesthetic shivering will be excluded. Types of outcomes This review will consider studies that include the following outcome measure: presence of postanesthetic shivering observed in the post-anesthesia care unit during the first hour after the completion of surgery. Intensity of shivering will be measured with variations of a shivering scale validated by Crossley and TRUNCATED AT 350 WORDS