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

Background: Post-operative shivering is very common and followed by many problems such as increasing oxygen consumption, blood pressure, intracranial and intraocular pressure, and post-operation pain. Therefore, prevention of shivering is important especially in elderly and ischemic heart disease patients. The goal of this study was comparing the effect of Pethidine (Meperidine), Dexamethasone and Placebo on prevention of shivering. Material and Methods: This double blind clinical trial study 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 temperature of patients was measured every 5 minute interval. After induction saline normal, Dexamethasone and Pethidine were injected to groups a, b and c respectively. In recovery all patients were controlled for visible shivering: All data were statistically analyzed by SPSS software and ANOVA and chi square tests. Results: There were no significant differences among three mentioned groups regarding of gender, age , duration of surgery and recovery time. Nineteen cases (47.5%) in group a had post-operative shivering. Whereas, in group b only 4 cases (10%) had shivering and the difference between 2 groups was significant (P value = 0.001). Also in group c, 15 cases (37.5%) had shivering that the difference with placebo group was significant (P value = 0.08). Conclusion: The present study showed that pethidine and dexamethasone are effective drugs for preventing of post-operative shivering in elective surgery. And the effect of dexamethasone in preventing the post – operative shivering is better than Pethidine. Dexamethasone can be administered after induction of anesthesia as an alternative to administration of Pethidine (as a common method of prevention and treatment of postoperative shivering) particularly in patients with hemodynamic instability