Perioperative medicine & outcomes
The Effect of Prophylactic Steroids on Shivering in Adults Undergoing Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Trials
Pooled result · Overall shiveringResult — go to the resultRelative risk 0.65 95% CI 0.52–0.82Authors' conclusion
Prophylactic steroid administration may be beneficial in reducing the risk of perioperative shivering. However, the quality of evidence in favor of steroids is very low.
Study context
- Population
- Adults undergoing surgery under spinal or GA
- Participants
- 3,148 adults · 25 randomized controlled trials (RCTs)
- Comparison
- Prophylactic steroids vs controls
- Outcome
- Perioperative (intra- and postoperative) shivering
Methodological detailsmeta-regression
- Meta-regression
Pooled result
Overall shivering
Relative risk
0.65
95% CI 0.52–0.82
P = 0.0002
Steroids vs Controls
RR 0.65 (95% CI 0.52–0.82); P = 0.0002
As reported in the abstract
Further pooled results
| Outcome | RR (95% CI) | P value | |
|---|---|---|---|
| Moderate to severe shiveringI2 = 61% | 0.49 (0.34–0.71) | P = 0.0002 | |
| 0.20.5125Relative risk (log scale) |
Overall shivering, hydrocortisone (subgroup)
| RR (95% CI) | P value | ||
|---|---|---|---|
| HydrocortisoneI2 = 58% | 0.51 (0.32–0.80) | P = 0.003 | |
| 0.20.5125Relative risk (log scale) |
Overall shivering, intrathecal dexamethasone (subgroup)
| RR (95% CI) | P value | ||
|---|---|---|---|
| Intrathecal dexamethasoneI2 = 56% | 0.84 (0.34–2.08) | P = 0.7 | |
| 0.20.5125Relative risk (log scale) |
- Moderate to severe shivering: prediction interval for risk of severity 0.23-1.0
- Overall shivering, intrathecal dexamethasone (subgroup): null hypothesis of no subgroup difference not rejected (P = .47)
Patient satisfaction and quality of recovery (QoR)
- Higher in the dexamethasone groups vs placebo
Meta-regression (dose, timing, type of anaesthesia)
- Dose, timing of steroids and type of anesthesia not significant
Safety
Steroid-related adverse events
- No increased risk vs placebo or controls
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
The Effect of Prophylactic Steroids on Shivering in Adults Undergoing Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Anesth Analg. Published 15 June 2023. doi:10.
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