Comparison Of The Dexmedetomidine And Tramadol In The Treatment Of Shivering:A Meta-Analysis

Objective:Shivering refers to the manifestation of involuntary rhythmic contraction of skeletal muscle,which is usually the body's response to cold body temperature regulation.The perioperative incidence of shivering is about 5% to 65%,which is one of the common complications.There are many clinical randomized controlled trials comparing dexmedetomidine and tramadol in the treatment of post-anesthesia shivering,but there is still a lack of systematic evaluation of the clinical effects and adverse effects of these two drugs.This article analyzed the current randomized controlled trials of dexmedetomidine and tramadol in the treatment of perioperative shivering,evaluating the clinical effects and adverse effects of the two drugs,and providing evidence-based medical evidence for clinical rational use.Methods:Computers searched PubMed,Cochrane,EMBASE,China Knowledge Network,and Wanfang database.The time limit was from January 2010 to December 2017.Data were extracted from the inclusion and exclusion criteria and meta-analysis was performed using RevMan5.3 software.Results:A total of 19 Chinese and English literatures were included for meta-analysis,totaling 1366 patients.Meta-analysis showed no statistically significant difference in the efficacy of dexmedetomidine versus tramadol in the treatment of shivering [RR=1,95%CI(0.98,1.03),p=0.81];The dexmedetomidine group had a shorter onset time for the treatment of shivering than the tramadol group [MD=-1.28,95% CI(-1.89,-0.67),p<0.00001];The recurrence rate of shivering was lower than that of the tramadol group[RR=0.26,95% CI(0.13,0.52),p=0.0001];The incidence of nausea and vomiting was lower than that of the tramadol group [RR=0.08,95% CI(0.05,0.13),p<0.00001];The Rampsay sedation score was higher than that of the tramadol group [MD=0.97,95% CI(0.76,1.19),p<0.00001].Conclusion:The efficacy of dexmedetomidine in the treatment of shivering is not statistically different from that of tramadol,but dexmedetomidine has a shorter onset time,lower recurrence rate,lower incidence of nausea and vomiting,and higher Rampsay sedation score.