Intrathecal Sufentanil Does Not Reduce Shivering During Neuraxial Anesthesia: A Meta-Analysis.

Abstract

BACKGROUND:

We performed this meta-analysis to evaluate the efficacy of intrathecal sufentanil in preventing shivering during neuraxial anesthesia.

MATERIAL/METHODS:

We searched the Cochrane Library, PubMed, and Embase for all randomized controlled trials (RCT) on use of intrathecal sufentanil for preventing shivering during neuraxial anesthesia. References of retrieved articles were also screened. The quality of the studies was evaluated by the method recommended by the Cochrane Collaboration. Meta-analysis was conducted using the Cochrane Collaboration's RevMan 5.3 software. The primary outcome was incidence and severity of shivering, and the secondary outcomes were drug-related complications of pruritus, nausea, vomiting, hypotension, and bradycardia.

RESULTS:

Eight original RCTs investigating a total of 1032 patients, of whom 599 received sufentanil and 473 received placebo, met the inclusion criteria. Compared to the placebo group, sufentanil did not reduce incidence of shivering (OR, 0.60; 95% CI, 0.35 to 1.01; P=0.06), but it increased the incidence of pruritus (OR, 12.52; 95% CI, 5.07 to 30.91; P<0.00001). Compared to the placebo group, sufentanil did not increase the incidence of nausea (OR, 0.69; 95% CI, 0.41 to 1.16; P=0.16), hypotension (OR, 0.93; 95% CI, 0.62 to 1.41; P=0.74), or bradycardia (OR, 0.86; 95% CI, 0.41 to 1.82; P=0.70). In addition, sufentanil reduced the incidence of vomiting during neuraxial anesthesia (OR, 0.45; 95% CI, 0.22 to 0.92; P=0.03).

CONCLUSIONS:

Neither epidural nor subarachnoid intrathecal sufentanil reduced shivering during neuraxial anesthesia, but it did increase the incidence of pruritus.

• Authors: Lin Shao Feng, Gao Hong, Zhao Yan, Liu Yan Qiu, Li An Liang
• Journal: Medical science monitor : international medical journal of experimental and clinical research (Med Sci Monit) Vol. 22 Pg. 258-66 (Jan 25 2016) ISSN: 1643-3750 [Electronic] United States
• PMID: 26806131 (Publication Type: Journal Article, Meta-Analysis)

Chemical References

• Placebos
• Sufentanil

Topics

• Anesthesia
• Bradycardia (epidemiology, etiology)
• Humans
• Hypotension (epidemiology, etiology)
• Incidence
• Injections, Spinal (adverse effects)
• Placebos
• Pruritus (epidemiology, etiology)
• Shivering (drug effects)
• Sufentanil (administration & dosage, adverse effects, pharmacology)
• Vomiting (epidemiology, etiology)