Comparison of the effectiveness of dexmedetomidine, meperidine and ketamine in the prevention of postoperative shivering.

OBJECTIVE

To compare the prophylactic effectiveness of dexmedetomidine, meperidine, and ketamine for postoperative shivering.

MATERIALS AND METHODS

A randomized, controlled, double-blind, clinical trial, including 160 patients (ASA I - II) undergoing surgical procedures under general anaesthesia for longer than one hour. They were randomly assigned to four groups to receive a single intravenous dose: Dexmedetomidine 1ug/kg (group A, n=33), meperidine 0.4mg/kg (group B, n=38), ketamine 0.5mg/kg (groupC, n=40), or 0.9% saline solution (group D, n=45), administered 20min before the skin suture. To avoid bias, the anaesthetic induction and maintenance technique, as well as postoperative follow-up was standardised.

RESULTS

For any level of shivering, the greatest incidence was observed in the placebo group (47%) (P<.01). The greatest effect on shivering level 3 and 4 occurred in the placebo group (22% and 18%, respectively). For levels 3 and 4 during follow-up, there was not a single case of shivering at any time in the meperidine group (P<.01). The placebo group (38%) had the highest proportion of patients requiring treatment for post-operative shivering (P<.01).

CONCLUSION

Meperidine given intravenously in a single dose of 0.4mg/kg is a useful means for preventing postoperative shivering.