Comparative efficacy of intravenous treatments for perioperative shivering in patients undergoing caesarean delivery under neuraxial anaesthesia: A systematic review and Bayesian network meta-analysis of randomised-controlled trials
Authors' conclusion
This network meta-analysis identified four effective intravenous treatments for shivering in patients undergoing caesarean delivery under neuraxial anaesthesia: dexmedetomidine, tramadol, nalbuphine and meperidine. Dexmedetomidine was the top-ranked intervention for all outcomes.
Study context
- Population
- Patients undergoing caesarean delivery under neuraxial anaesthesia with perioperative shivering
- Participants
- 1,983 patients · 20 RCTs
- Comparison
- IV treatments for perioperative shivering vs saline
- Outcome
- Shivering control (cessation or significant reduction in intensity)
Methodological detailsCochrane risk of bias assessment
- Cochrane risk of bias assessment
Pooled result
As reported in the abstract
Effective treatment of shivering
Dexmedetomidine
0.87
SUCRA
Tramadol
0.85
SUCRA
Nalbuphine
0.74
SUCRA
Meperidine
0.66
SUCRA
Ondansetron
0.41
SUCRA
Clonidine
0.3
SUCRA
Amitriptyline
0.03
SUCRA
Each group vs salineOdds ratio (95% CrI)
Dexmedetomidine
38.1(14.2–111.5)
Tramadol
33.6(15.1–81.8)
Nalbuphine
26.2(10.8–80.2)
Meperidine
20.9(6.2–73.1)
Ondansetron
6.6(2.2–23.2)
Clonidine
3.2(0.6–14.9)
Further pooled results
Time to shivering control, shivering recurrence
- Dexmedetomidine top-ranked intervention
Safety
Maternal nausea
- Dexmedetomidine top-ranked intervention
Original publication
Comparative efficacy of intravenous treatments for perioperative shivering in patients undergoing caesarean delivery under neuraxial anaesthesia: A systematic review and Bayesian network meta-analysis of randomised-controlled trials. J Clin Anesth. Published 27 November 2024. doi:10.
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