The Efficacy Of Various Drugs In Preventing Shiver After General Anesthesia: A Meta-analysis

Objective: To Provide a meta一analysis of the studies on the efficacy of variousDrugs in preventing shiver after general anesthesia.Method: Articles in English or Chinese published in Pubmed，springer，Sciencedirect Onsite Database，Ovid Database，VIP journal full-text database，Wanfang Database，china national knowledge infrastructure，Chinese Biomedicaldatabase were searched up to February2014,in which the following search terms wereused：“drug, general anesthesia and shiver or rigor”，and manual or computer retrievalrelated magazines. Inclusion criteria and Exclusion criteria were formulatedstrictly as required，all Articles in connection with various drugs in preventingshiver after general anesthesia were inclusion，more then two related articlesobtained were provide a meta一analysis. Randomized clinical trial(RCT)would beassessed for qualities according to the Jadad scale and the concealment of treatmentallocation. The trial design, Participant, type of intercention and outcomemeasurement in the obtained articles, where the Number of the articles was more than2pieces on one specific agent, were independently assessed by two reviewers. TheRevman5.2software was used to review management and analysis. The results wereexpressed as odds ratio(OR)and confidence internals (CI) for dichotomous outcomes,and forest plot was obtained.I>40%and P<0.1were used to indicate heterogeneity andthe funnel plot And fale-safe number to assess bias. The sensitivity analyze werecarried out According to characteristics of the studies involved.Results: A total of39articles were finalized identified according to thesearch criteria and26articles were included in the Meta-analysis. Themethodological quality of the articles was relatively high. Parecoxib(OR=0.14,95%CI0.04-0.54) tramadol (OR=0.13,95%CI0.08-0.22)、dexmedetomidine （OR=0.13,95%CI0.09-0.21）、clodine were found to have a protective against shiver after generalanesthesia.The reaserch made a subgroup analysis of the include study according tointervention time.The results showed that giving tramadol after the surgery （OR=0.16,95%CI0.06-0.44）or before the anesthesia induction (OR=0.04,95%CI0.01-0.13) bothhave a protective against shiver after general anesthesia. The reaserch made asubgroup analysis of the include study according to intervention measure. The resultsshowed that giving dexmedetomidine30minutes before the end of surgery(OR=0.10,95%CI0.04-0.28) or single-dose before the anesthesia induction(OR=0.07,95%CI0.01-0.32) and single-dose before the anesthesia induction also onthe maintenance of anesthesia (OR=0.17,95%CI0.08-0.34) all have a protectiveagainst shiver after general anesthesia.Conclusions: This Meta-analysis found that Parecoxib、tramadol、dexmedetomid、clodine had prophylactic effects in preventing shiver after general anesthesia.