Date of Presentation
5-2-2024 12:00 AM
College
Rowan-Virtua School of Osteopathic Medicine
Poster Abstract
Introduction: Shivering is a frequently encountered perioperative complication in patients undergoing spinal anesthesia. Numerous different pharmacological agents have been employed to mitigate this issue.
Objective: This scoping review aims to evaluate the efficacy of ketamine in mitigating the incidence of shivering.
Methods: "Pubmed," "Jama," and "Cochrane" were used as primary databases. Searches were performed using combinations of key terms: "Ketamine," "Shivering," "Spinal Anesthesia," and "Hypothermia."
Results: In ketamine versus control, three out of five studies found ketamine to be more effective (p<0.05, p<0.001, p<0.001) in the prevention of shivering. When compared with tramadol, two studies found ketamine to be more effective (p<0.001, p<0.001), one found no difference (p=0.261), and one found tramadol to be more effective (p<0.001). Two studies found dexmedetomidine more effective (p<0.022, p<0.027) than ketamine and tramadol. When comparing ketamine, ondansetron, and pethidine, all three were effective (P<0.001) versus saline, with no significant difference between the three. Meperidine demonstrated more efficacy (p<0.05) in reducing the intensity of shivering than ketamine. Ketamine's effects on hemodynamics were shown to be equivocal or more favorable across several studies.
Conclusion: Ketamine is an effective and safe drug for preventing perioperative shivering. While there is mixed evidence on whether it is better than other treatments, ketamine may have advantages from a hemodynamics standpoint. However, doctors should be cautious when prescribing it to patients who might be prone to delirium due to its association with hallucinations. Overall, ketamine is a safe and effective drug for the prevention of perioperative shivering.
Keywords
Ketamine, shivering, spinal anesthesia, perioperative complication, hemodynamics, hypothermia
Document Type
Poster
YouTube Video Link
A Scoping Review: Ketamine for the Prevention of Perioperative Shivering in Patients Undergoing Spinal Anesthesia
Introduction: Shivering is a frequently encountered perioperative complication in patients undergoing spinal anesthesia. Numerous different pharmacological agents have been employed to mitigate this issue.
Objective: This scoping review aims to evaluate the efficacy of ketamine in mitigating the incidence of shivering.
Methods: "Pubmed," "Jama," and "Cochrane" were used as primary databases. Searches were performed using combinations of key terms: "Ketamine," "Shivering," "Spinal Anesthesia," and "Hypothermia."
Results: In ketamine versus control, three out of five studies found ketamine to be more effective (p<0.05, p<0.001, p<0.001) in the prevention of shivering. When compared with tramadol, two studies found ketamine to be more effective (p<0.001, p<0.001), one found no difference (p=0.261), and one found tramadol to be more effective (p<0.001). Two studies found dexmedetomidine more effective (p<0.022, p<0.027) than ketamine and tramadol. When comparing ketamine, ondansetron, and pethidine, all three were effective (P<0.001) versus saline, with no significant difference between the three. Meperidine demonstrated more efficacy (p<0.05) in reducing the intensity of shivering than ketamine. Ketamine's effects on hemodynamics were shown to be equivocal or more favorable across several studies.
Conclusion: Ketamine is an effective and safe drug for preventing perioperative shivering. While there is mixed evidence on whether it is better than other treatments, ketamine may have advantages from a hemodynamics standpoint. However, doctors should be cautious when prescribing it to patients who might be prone to delirium due to its association with hallucinations. Overall, ketamine is a safe and effective drug for the prevention of perioperative shivering.