Ketamine use can prevent postanesthetic shivering without severe side effects
China: Ketamine can prevent postanesthetic shivering without severe side effects, a recent study in the journal BMC Anesthesiology. The study further found that ketamine, however, showed no advantage over other used anti-shivering drugs.
Postanesthetic shivering is a frequent complication of anesthesia that accounts for much discomfort in postoperative patients and increases postoperative complications in high-risk patients. It is characterized by the involuntary movement that may affect one or more muscle groups and is a very unpleasant and physiologically stressful experience. Due to the lack of high-quality evidence, it is difficult to draw a conclusion about optimal anti-shivering medication.
The main purpose of this meta-analysis by Jun-Li Cao, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China, and colleagues was to analyze and evaluate the efficacy and safety of prophylactic use of ketamine for preventing postanesthetic shivering.
The researchers searched the online databases for randomized controlled trials and selected a total of 16 trials including 1485 patients.
The primary outcome observed was the difference of the incidence rate of postanesthetic shivering between ketamine group and placebo group. The secondary outcomes were the sedation score and incidence of the side effects caused by ketamine and any other drugs utilized in the studies.
Key findings of the study include:
- Ketamine reduced the incidence rate of postanesthetic shivering compared to a placebo (odds ratio [OR]: 0.13).
- Regarding side effects, there was no evident variability of the incidence of nausea and vomiting.
- Usage of ketamine was associated with a lower rate of hypotension and bradycardia when compared to a placebo.
- Hallucinations were more frequently observed in patients who received higher doses of ketamine.
- No significant difference was found in the incidence of postanesthetic shivering with ketamine versus other pharmacological interventions.
"Ketamine is of clinical value, but further studies should be performed on a wider scale to determine more emphasized results. Furthermore, larger clinical trials investigating the combination of different anti-shivering regimens are warranted," concluded the authors.
The study, "Efficacy and safety of prophylactic use of ketamine for prevention of postanesthetic shivering: a systematic review and meta analysis," is published in the journal BMC Anesthesiology.