The Efficacy of Dexamethasone in the Prevention of Postoperative Shivering: A Double-Blind Placebo-Controlled Clinical Trial

Background: Postoperative shivering is very common and could be followed by many problems such as increasing in oxygen consumption, blood pressure, intracranial and intraocular pressure, and postoperative pain. Therefore, the prevention of shivering is important especially in the elderly and ischemic heart disease patients. The goal of this study was to compare the efficacy of pethidine (meperidine), dexamethasone, and placebo in the prevention of postoperative shivering. Methods: This double-blind placebo-controlled clinical trial was carried out on 120 patients who were candidates for surgery under general anesthesia. The patients were randomly divided into three groups including those who received placebo (a), dexamethasone (b), and pethidine (c). Induction and maintenance of anesthesia for all patients were similar. Central and peripheral temperatures of patients were measured every 5-minute. After induction, normal saline, dexamethasone, and pethidine were injected to groups a, b, and c, respectively. In recovery phase, all patients were monitored for visible shivering. Findings: There was no significant difference between the three groups regarding gender, age, duration of surgery, and recovery time. Nineteen cases (47.5%) in group (a) had postoperative shivering compared with the 4 cases (10%) in group (b) and the difference between 2 groups was significant (P = 0.001). Similarly, in group (c), 15 cases (37.5%) had shivering that was significantly lower than the placebo group (P = 0.08). Conclusion: The present study showed that pethidine and dexamethasone are effective in preventing postoperative shivering in elective surgeries under general anesthesia. Moreover, dexamethasone is markedly more effective than pethidine. Dexamethasone can be administered after induction of anesthesia as an alternative to pethidine particularly in patients with hemodynamic instability. Keywords: General anesthesia, Postoperative complications, Shivering, Dexamethasone, Meperidine