Abstract
BackgroundShivering is a very common complication in the postanesthesia period. Increasing studies have reported ondansetron may be effective in prevention of postanesthesia shivering (PAS). However, the results remained controversial; hence we conducted a meta-analysis of randomized controlled trials to evaluate the efficacy and safety of ondansetron on the prevention of postanesthesia shivering.MethodsPubMed and Embase databases were searched to identify the eligible randomized controlled trials assessing the effect of ondansetron on the prevention of PAS. Results were expressed as risk ratios (RRs) with accompanying 95% confidence intervals (CIs). The meta-analysis was performed with fixed-effect model or random-effect model according to the heterogeneity.ResultsSix trials including 533 subjects were included. Compared with placebo, ondansetron was associated with a significant reduction of PAS (RR 0.43, 95% CI, 0.27-0.70), without an increased risk of bradycardia (RR 0.37, 95% CI, 0.12-1.15). Compared with meperidine, no difference was observed in the incidence of PAS (RR 0.68, 95% CI, 0.39-1.19) and bradycardia (RR 2.0, 95% CI, 0.38-10.64).ConclusionsOndansetron has a preventive effect on PAS without a paralleled side effect of bradycardia.
Highlights
Shivering is a very common complication in the postanesthesia period
Shivering, a very common complication of surgery owing to postoperative pain and postanesthesia hypothermia, is distressing for both patients and clinicians [1]
It can be defined as involuntary and oscillatory muscular activities that increase the metabolic rate by two to three folds to maintain the core temperature, with the increment of heat production by only 200% in adults [2]. Both neuraxial and general anesthesia are associated with a significant incidence of shivering, and the incidence is 40%-60% in regional anesthetic patients [3] and up to 60% in general anesthetic ones [4]
Summary
Shivering is a very common complication in the postanesthesia period. Increasing studies have reported ondansetron may be effective in prevention of postanesthesia shivering (PAS). A very common complication of surgery owing to postoperative pain and postanesthesia hypothermia, is distressing for both patients and clinicians [1] It can be defined as involuntary and oscillatory muscular activities that increase the metabolic rate by two to three folds to maintain the core temperature, with the increment of heat production by only 200% in adults [2]. Shivering can be associated with severe adverse effects by increasing the oxygen consumption and carbon dioxide retention. It can cause arterial hypoxia, increase cardiac output and the Recent years, with increasing awareness of its undesirable aftermath, effective prevention of postanesthesia shivering (PAS) is being imperative. Clonidine, a partial α2 adrenergic agonist, is related to bradycardia, hypotension and sedation [10]
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