Shivering Management in Spinal Anesthesia: Evaluating the Role of Ketamine: A Narrative Review
-
Siavash Sangi
,
Mehrdad Mesbah Kiaei
,
Shahnam Sedigh Maroufi
,
Maryam Aligholizadeh
,
Parisa Moradimajd
,
Azam Saei
Abstract
Background: Shivering is one of the most prevalent known complications due to dysregulation in the thermoregulatory system following regional anesthesia, with an incidence of 65%, leading to unpleasant outcomes and decreased patient satisfaction. Ketamine, a weak analgesic, affects the thermoregulatory center.
Methods: The authors conducted a search and selection of articles using reputable scientific databases. The search keywords included Shivering, Ketamine, and Spinal Anesthesia. The selected articles summarized the literature findings related to ketamine and shivering after spinal anesthesia.
Results: This narrative review synthesizes findings from multiple studies examining the role of ketamine in managing shivering following spinal anesthesia. Based on the results obtained, 10 areas were examined: Definition of shivering, Epidemiology of postoperative shivering, Pathophysiology of shivering, Risk factors for post-spinal anesthesia shivering, Spinal anesthesia, its benefits, and its impact on shivering, Post-anesthetic shivering (PAS) complications, Risk factors for postoperative shivering, Control and management of post-anesthetic shivering (PAS) dosage, Effective timing and benefits of ketamine administration in postoperative shivering.
Conclusions: The effectiveness of ketamine in preventing shivering after spinal anesthesia is evident from the mixed results of studies. Ketamine, regardless of dosage, can be effective in reducing shivering after spinal anesthesia based on the mentioned criteria. Standardized research with precise methods to determine optimal dosages and ensure safety is necessary.
[1] Bafghi NN, Salagegheh S, Kermani MS, Valeh H, Hakimpour S. Prevalence of Post Anesthesia Complications and Their Related Factors in Urologic Surgery. J Pharm Negat Results. 2023; 14(2):3534-43.
[2] Mullainayaki K, Mirunalini G, Ramani CKS. Intravenous Ketamine for Prevention of Post Anesthetic Shivering In Urological Procedures Done Under Spinal Anesthesia: A Randomized Triple Blinded Placebo Controlled Trial. Annals of Medical and Health Sciences Research. 2023; 13(1):425-430.
[3] Khan T, Yadav M, Geetha S, Gopinath R, Durga P, Chowdary H. Comparison between Dexmedetomidine, Ketamine and Tramadol for Prevention of Perioperative Shivering under Spinal Anaesthesia: A Randomised Clinical Trial. Journal of Clinical and Diagnostic Research. 2022; 16(12).
[4] Fenta E, Kibret S, Hunie M, Tamire T, Fentie Y, Seid S, et al. The effects of intravenous tramadol vs. intravenous ketamine in the prevention of shivering during spinal anesthesia: A meta-analysis of randomized controlled trials. Front Med (Lausanne). 2022; 9: 1011953.
[5] Gholami H, Moradi Y, Khazaei Z, Tehrani S. A comparison of the effect of dexamethasone and pethidine for prevention of shivering after spinal anesthesia in caesarean section: randomization clinical trial. Biomedical Research and Therapy. 2018; 5(9):2646-50.
[6] Mohammadzadeh Jouryabi A, Sharami SH, Mansour Ghanaie M, Sedighinejad A, Imantalab V, Rafiee Sorouri Z, et al. Comparing the Effects of Low Dose of Ketamine, Tramadol, and Ondansetron in Prevention of Post Spinal Anesthesia Shivering in Cesarean Section. Anesth Pain Med. 2021; 11(4):e116429.
[7] Maroufi SS, Kiaei MM, Aligholizadeh M, Saei A, Sangi S, Akbarpour P. The Effect of Ketamine Administration on the Incidence of Delirium After Coronary Artery Bypass Graft Surgery: A Scoping Review. Journal of Cellular & Molecular Anesthesia. 2024.
[8] Gemechu AD, Gebremedhin TD, Andebiku AA, Solomon F, Sorsa A. The effect of ketamine versus tramadol on prophylactic post-spinal shivering in those patients undergoing orthopedic surgery: a prospective cohort study design, 2020. BMC Anesthesiol. 2022; 22(1):361.
[9] Lema GF, Gebremedhn EG, Gebregzi AH, Desta YT, Kassa AA. Efficacy of intravenous tramadol and low-dose ketamine in the prevention of post-spinal anesthesia shivering following cesarean section: a double-blinded, randomized control trial. Int J Womens Health. 2017; 9:681-688.
[10] Petskul S, Kitsiripant C, Rujirojindakul P, Chantarokorn A, Jullabunyasit A, Thinchana S. Prophylactic low-dose ketamine to prevent post anesthetic shivering in orthopedic surgery: a randomized-controlled study. J Med Assoc Thai. 2016; 99(4):400-5.
[11] Dadkhah P, Hashemi M, Gharaei B, Bigdeli MH, Solhpour A. Comparison of post-spinal back pain after midline versus paramedian approaches for urologic surgeries. Journal of Anesthesiology. 2020;12(1).
[12] Babajani A, Mohebi T, Ahmadi M, Karimi A. Selection Spinal Anesthesia Against an Unusual Finding: A Case Report Hairy Patch. Archives of Anesthesiology and Critical Care. 2024.
[13] Zeng W, Shi Y, Zheng Q, Du S. Ultrasound-assisted modified paramedian technique for spinal anesthesia in elderly. BMC anesthesiology. 2022; 22(1):242.
[14] Firdous T, Siddiqui MA, Siddiqui SM. Frequency of post dural puncture headache in patients undergoing elective cesarean section under spinal anesthesia with median versus paramedian approach. Anaesthesia, Pain & Intensive Care. 2019:165-70.
[15] Babajani A, Feizollahzadeh N, Koohsoltani H. Occurrence of Total Spinal Anesthesia after Caudal Anesthesia in a Newborn Patient: A Case Report of a Challenging Complication. Archives of Anesthesiology and Critical Care. 2024.
[16] Usta B, Gozdemir M, Demircioglu RI, Muslu B, Sert H, Yaldiz A. Dexmedetomidine for the prevention of shivering during spinal anesthesia. Clinics (Sao Paulo). 2011; 66(7):1187-91.
[17] DICTIONARY O. nd Disponível em: https://www. oxfordlearnersdictionaries. com. Access; 2022.
[18] Alfonsi P. Postanaesthetic shivering. Epidemiology, pathophysiology and approaches to prevention and management. Minerva Anestesiol. 2003; 69(5):438-42.
[19] Nirala DK, Prakash J, Ram B, Kumar V, Bhattacharya PK, Priye S. Randomized double-blinded comparative study of intravenous nalbuphine and tramadol for the treatment of postspinal anesthesia shivering. Anesth Essays Res. 2020; 14(3):510-514.
[20] Yimer HT, Hailekiros AG, Tadesse YD. Magnitude and associated factors of postanaesthesia shivering among patients who operated under general and regional anesthesia, Northwest Ethiopia: a cross sectional study. Anesthesia & Clinical Research. 2015; 6(11):1-5.
[21] Jankovic J, Fahn S. Physiologic and pathologic tremors. Diagnosis, mechanism, and management. Ann Intern Med. 1980; 93(3):460-5.
[22] Babajani A, Sajadi AS, Beiranvand ZP, Taghizadeh S, Moradimajd P. Improving Safety and Reducing Clinical Errors in Anesthesia: Which Checklist Is Your Choice? Archives of Anesthesiology and Critical Care. 2024.
[23] Babajani A, Moradimajd P, Saei A, Abolghasemi J. Development and Psychometrics of Safe Anesthesia Evaluation. Three-Step Checklist (Pre-Induction of Anesthesia, Maintenance of Anesthesia, Post-Anesthesia): A Cross Sectional Study. Archives of Anesthesiology and Critical Care. 2024;10(1):66-74.
[24] Sangi S, Alipour N, Manouchehrian N, Aligholizadeh M. Comparative Efficacy of Intravenous Midazolam, Midazolam-Ketamine, and Ketamine in Reducing the Prevalence of Post-Spinal Shivering: A Double-Blind Clinical Trial. Bulletin of Pharmaceutical Sciences Assiut University. 2024.
[25] Botros JM, Mahmoud AMS, Ragab SG, Ahmed MAA, Roushdy HMS, Yassin HM, et al. Comparative study between Dexmedetomidine and Ondansteron for prevention of post spinal shivering. A randomized controlled trial. BMC anesthesiology. 2018; 18:1-8.
[26] Neaton K, Voldanova L, Kiely T, Nagle C. Non-pharmacological treatments for shivering post neuraxial anaesthesia for caesarean section: a scoping review. Contemp Nurse. 2024; 60(1):42-53.
[27] Abdel-Fattah AM, Hamzawy HA-EH, Noor El-Din T. Preventive Effect of Intraoperative Dexmedetomedine, Ketamine, Magnesium Sulfate on Perioperative Shivering Related to Transuretheral Resection of the Prostate [TURB]; A randomized Controlled Study. International Journal of Medical Arts. 2022; 4(2).
[28] He Y, Feng Y-G, He J, Liang B, Jiang M-D, Liu J, et al. Effects of irrigation fluid temperature during flexible ureteroscopic holmium laser lithotripsy on postoperative fever and shivering: a randomized controlled trial. BMC urology. 2021; 21(1):72.
[29] Nakamura K, Morrison SF. Preoptic mechanism for cold-defensive responses to skin cooling. J Physiol. 2008; 586(10):2611-20.
[30] Nakamura K, Morrison SF. Central efferent pathways for cold‐defensive and febrile shivering. J Physiol. 2011; 589(14):3641-58.
[31] Qi X, Chen D, Li G, Cao J, Yan Y, Li Z, et al. Risk factors associated with intraoperative shivering during caesarean section: a prospective nested case-control study. BMC Anesthesiology. 2022; 22(1).
[32] Eberhart LH, Döderlein F, Eisenhardt G, Kranke P, Sessler DI, Torossian A, et al. Independent risk factors for postoperative shivering. Anesthesia & Analgesia;101(6):1849-57.
[33] Sadeh SS, Hashemi E, Aminnejad R, Bastanhagh E. The impact of optimal dose of ketamine on shivering following elective abdominal hysterectomy: a randomised comparative study. Anesth Pain Med. 2020; 10(5):e106220.
[34] Sadeghi J, Bazzazi S, Fattahi F, Mousavi MA, Tajbakhsh A, Rassouli S, et al. Impact of analgesics on the risk of ovarian cancer; a systematic review and meta-analysis of cohort and case-control studies. Immunopathologia Persa. 2023.
[35] Crossley A, Mahajan R. The intensity of postoperative shivering is unrelated to axillary temperature. Anaesthesia. 1994; 49(3).
[36] Lenhardt R, Grady M, Kurz A. Hyperthermia during anaesthesia and intensive care unit stay. Best Pract Res Clin Anaesthesiol. 2008; 22(4):669-94.
[37] Reynolds L, Beckmann J, Kurz A. Perioperative complications of hypothermia. Best Pract Res Clin Anaesthesiol. 2008; 22(4):645-57.
[38] Fenta E, Kibret S, Hunie M, Tamire T, Fentie Y, Seid S, et al. The effects of intravenous tramadol vs. intravenous ketamine in the prevention of shivering during spinal anesthesia: A meta-analysis of randomized controlled trials. Front Med (Lausanne). 2022; 9:1011953.
[39] Kiekkas P, Poulopoulou M, Papahatzi A, Souleles P. Effects of hypothermia and shivering on standard PACU monitoring of patients. AANA journal. 2005; 73(1):47.
[40] Davis AJ, Bissonnette B. Thermal regulation and mild intraoperative hypothermia. Curr Opin Anaesthesiol. 1999; 12(3):303-9.
[41] Zhou Y, Mannan A, Han Y, Liu H, Guan HL, Gao X, Dai MS, Cao JL. Efficacy and safety of prophylactic use of ketamine for prevention of postanesthetic shivering: a systematic review and meta-analysis. BMC Anesthesiol. 2019; 19(1):245.
[42] Faraz A, Islam H, Jahangir M, Ashfaq F. Comparing The Effects of Low Doses of Ketamine and Tramadol In The Prevention Of Post-Spinal Anesthesia Shivering In Cesarean Section. Biological and Clinical Sciences Research Journal. 2023; 4(1).
[43] Islam MR, Karim M, Haque AMZ. Examination of Three Distinct Dosages of Dexmedetomidine for Counteraction of Postspinal Sedation Shivering in Transurethral Resection of Prostate (TURP) Medical Procedure. EAS Journal of Anaesthesiology and Critical Care. 2022; 4(4).
[44] Morsali SF, Movasseghi G, Kiaee MM, Ghorbanloo M, Mohaghegh MR, Morsali A, et al. Clonidine versus tramadol for postanesthetic shivering: A randomized clinical trial study. Biomedical Research and Therapy. 2017;4(10):1716-32.
[45] Saheban Maleki M, Sedaghati Ansari S, Rezaniazave F, Talai A. Comparing Intravenous Dexamethasone, Pethidine, and Ketamine for Postoperative Shivering Prevention in Patients Undergoing General Anesthesia. Internal Medicine Today. 2021;27(3):288-301.
[46] Morgan CJ, Curran HV, Drugs ISCo. Ketamine use: a review. Addiction. 2012; 107(1).
[47] Mazzeffi M, Johnson K, Paciullo C. Ketamine in adult cardiac surgery and the cardiac surgery intensive care unit: an evidence-based clinical review. Ann Card Anaesth. 2015; 18(2):202-9.
[48] Hudetz J, Iqbal Z, Gandhi S, Patterson K, Byrne A, Hudetz A, et al. Ketamine attenuates post‐operative cognitive dysfunction after cardiac surgery. Acta Anaesthesiologica Scandinavica. 2009; 53(7):864-72.
[49] Hovaguimian F, Tschopp C, Beck‐Schimmer B, Puhan M. Intraoperative ketamine administration to prevent delirium or postoperative cognitive dysfunction: A systematic review and meta‐analysis. Acta Anaesthesiol Scand. 2018; 62(9):1182-93.
[50] Sarshivi F, Ghaderi E, Sarshivi A, Shami S, Nasseri K. Intravenous ketamine for the prevention of post anesthetic shivering in spinal anesthesia: A randomized double-blind placebo-controlled trial. Acta Medica Iranica. 2020; 58(10):479-85.
[51] Thangavelu R, George SK, Kandasamy R. Prophylactic low dose ketamine infusion for prevention of shivering during spinal anesthesia: A randomized double-blind clinical trial. J Anaesthesiol Clin Pharmacol. 2020; 36(4):506-510.
[52] Seyam SH. Prevention of post-spinal anesthesia shivering: Low dose ketamine vs tramadol. Al-Azhar International Medical Journal. 2020;1(4):108-15.
[2] Mullainayaki K, Mirunalini G, Ramani CKS. Intravenous Ketamine for Prevention of Post Anesthetic Shivering In Urological Procedures Done Under Spinal Anesthesia: A Randomized Triple Blinded Placebo Controlled Trial. Annals of Medical and Health Sciences Research. 2023; 13(1):425-430.
[3] Khan T, Yadav M, Geetha S, Gopinath R, Durga P, Chowdary H. Comparison between Dexmedetomidine, Ketamine and Tramadol for Prevention of Perioperative Shivering under Spinal Anaesthesia: A Randomised Clinical Trial. Journal of Clinical and Diagnostic Research. 2022; 16(12).
[4] Fenta E, Kibret S, Hunie M, Tamire T, Fentie Y, Seid S, et al. The effects of intravenous tramadol vs. intravenous ketamine in the prevention of shivering during spinal anesthesia: A meta-analysis of randomized controlled trials. Front Med (Lausanne). 2022; 9: 1011953.
[5] Gholami H, Moradi Y, Khazaei Z, Tehrani S. A comparison of the effect of dexamethasone and pethidine for prevention of shivering after spinal anesthesia in caesarean section: randomization clinical trial. Biomedical Research and Therapy. 2018; 5(9):2646-50.
[6] Mohammadzadeh Jouryabi A, Sharami SH, Mansour Ghanaie M, Sedighinejad A, Imantalab V, Rafiee Sorouri Z, et al. Comparing the Effects of Low Dose of Ketamine, Tramadol, and Ondansetron in Prevention of Post Spinal Anesthesia Shivering in Cesarean Section. Anesth Pain Med. 2021; 11(4):e116429.
[7] Maroufi SS, Kiaei MM, Aligholizadeh M, Saei A, Sangi S, Akbarpour P. The Effect of Ketamine Administration on the Incidence of Delirium After Coronary Artery Bypass Graft Surgery: A Scoping Review. Journal of Cellular & Molecular Anesthesia. 2024.
[8] Gemechu AD, Gebremedhin TD, Andebiku AA, Solomon F, Sorsa A. The effect of ketamine versus tramadol on prophylactic post-spinal shivering in those patients undergoing orthopedic surgery: a prospective cohort study design, 2020. BMC Anesthesiol. 2022; 22(1):361.
[9] Lema GF, Gebremedhn EG, Gebregzi AH, Desta YT, Kassa AA. Efficacy of intravenous tramadol and low-dose ketamine in the prevention of post-spinal anesthesia shivering following cesarean section: a double-blinded, randomized control trial. Int J Womens Health. 2017; 9:681-688.
[10] Petskul S, Kitsiripant C, Rujirojindakul P, Chantarokorn A, Jullabunyasit A, Thinchana S. Prophylactic low-dose ketamine to prevent post anesthetic shivering in orthopedic surgery: a randomized-controlled study. J Med Assoc Thai. 2016; 99(4):400-5.
[11] Dadkhah P, Hashemi M, Gharaei B, Bigdeli MH, Solhpour A. Comparison of post-spinal back pain after midline versus paramedian approaches for urologic surgeries. Journal of Anesthesiology. 2020;12(1).
[12] Babajani A, Mohebi T, Ahmadi M, Karimi A. Selection Spinal Anesthesia Against an Unusual Finding: A Case Report Hairy Patch. Archives of Anesthesiology and Critical Care. 2024.
[13] Zeng W, Shi Y, Zheng Q, Du S. Ultrasound-assisted modified paramedian technique for spinal anesthesia in elderly. BMC anesthesiology. 2022; 22(1):242.
[14] Firdous T, Siddiqui MA, Siddiqui SM. Frequency of post dural puncture headache in patients undergoing elective cesarean section under spinal anesthesia with median versus paramedian approach. Anaesthesia, Pain & Intensive Care. 2019:165-70.
[15] Babajani A, Feizollahzadeh N, Koohsoltani H. Occurrence of Total Spinal Anesthesia after Caudal Anesthesia in a Newborn Patient: A Case Report of a Challenging Complication. Archives of Anesthesiology and Critical Care. 2024.
[16] Usta B, Gozdemir M, Demircioglu RI, Muslu B, Sert H, Yaldiz A. Dexmedetomidine for the prevention of shivering during spinal anesthesia. Clinics (Sao Paulo). 2011; 66(7):1187-91.
[17] DICTIONARY O. nd Disponível em: https://www. oxfordlearnersdictionaries. com. Access; 2022.
[18] Alfonsi P. Postanaesthetic shivering. Epidemiology, pathophysiology and approaches to prevention and management. Minerva Anestesiol. 2003; 69(5):438-42.
[19] Nirala DK, Prakash J, Ram B, Kumar V, Bhattacharya PK, Priye S. Randomized double-blinded comparative study of intravenous nalbuphine and tramadol for the treatment of postspinal anesthesia shivering. Anesth Essays Res. 2020; 14(3):510-514.
[20] Yimer HT, Hailekiros AG, Tadesse YD. Magnitude and associated factors of postanaesthesia shivering among patients who operated under general and regional anesthesia, Northwest Ethiopia: a cross sectional study. Anesthesia & Clinical Research. 2015; 6(11):1-5.
[21] Jankovic J, Fahn S. Physiologic and pathologic tremors. Diagnosis, mechanism, and management. Ann Intern Med. 1980; 93(3):460-5.
[22] Babajani A, Sajadi AS, Beiranvand ZP, Taghizadeh S, Moradimajd P. Improving Safety and Reducing Clinical Errors in Anesthesia: Which Checklist Is Your Choice? Archives of Anesthesiology and Critical Care. 2024.
[23] Babajani A, Moradimajd P, Saei A, Abolghasemi J. Development and Psychometrics of Safe Anesthesia Evaluation. Three-Step Checklist (Pre-Induction of Anesthesia, Maintenance of Anesthesia, Post-Anesthesia): A Cross Sectional Study. Archives of Anesthesiology and Critical Care. 2024;10(1):66-74.
[24] Sangi S, Alipour N, Manouchehrian N, Aligholizadeh M. Comparative Efficacy of Intravenous Midazolam, Midazolam-Ketamine, and Ketamine in Reducing the Prevalence of Post-Spinal Shivering: A Double-Blind Clinical Trial. Bulletin of Pharmaceutical Sciences Assiut University. 2024.
[25] Botros JM, Mahmoud AMS, Ragab SG, Ahmed MAA, Roushdy HMS, Yassin HM, et al. Comparative study between Dexmedetomidine and Ondansteron for prevention of post spinal shivering. A randomized controlled trial. BMC anesthesiology. 2018; 18:1-8.
[26] Neaton K, Voldanova L, Kiely T, Nagle C. Non-pharmacological treatments for shivering post neuraxial anaesthesia for caesarean section: a scoping review. Contemp Nurse. 2024; 60(1):42-53.
[27] Abdel-Fattah AM, Hamzawy HA-EH, Noor El-Din T. Preventive Effect of Intraoperative Dexmedetomedine, Ketamine, Magnesium Sulfate on Perioperative Shivering Related to Transuretheral Resection of the Prostate [TURB]; A randomized Controlled Study. International Journal of Medical Arts. 2022; 4(2).
[28] He Y, Feng Y-G, He J, Liang B, Jiang M-D, Liu J, et al. Effects of irrigation fluid temperature during flexible ureteroscopic holmium laser lithotripsy on postoperative fever and shivering: a randomized controlled trial. BMC urology. 2021; 21(1):72.
[29] Nakamura K, Morrison SF. Preoptic mechanism for cold-defensive responses to skin cooling. J Physiol. 2008; 586(10):2611-20.
[30] Nakamura K, Morrison SF. Central efferent pathways for cold‐defensive and febrile shivering. J Physiol. 2011; 589(14):3641-58.
[31] Qi X, Chen D, Li G, Cao J, Yan Y, Li Z, et al. Risk factors associated with intraoperative shivering during caesarean section: a prospective nested case-control study. BMC Anesthesiology. 2022; 22(1).
[32] Eberhart LH, Döderlein F, Eisenhardt G, Kranke P, Sessler DI, Torossian A, et al. Independent risk factors for postoperative shivering. Anesthesia & Analgesia;101(6):1849-57.
[33] Sadeh SS, Hashemi E, Aminnejad R, Bastanhagh E. The impact of optimal dose of ketamine on shivering following elective abdominal hysterectomy: a randomised comparative study. Anesth Pain Med. 2020; 10(5):e106220.
[34] Sadeghi J, Bazzazi S, Fattahi F, Mousavi MA, Tajbakhsh A, Rassouli S, et al. Impact of analgesics on the risk of ovarian cancer; a systematic review and meta-analysis of cohort and case-control studies. Immunopathologia Persa. 2023.
[35] Crossley A, Mahajan R. The intensity of postoperative shivering is unrelated to axillary temperature. Anaesthesia. 1994; 49(3).
[36] Lenhardt R, Grady M, Kurz A. Hyperthermia during anaesthesia and intensive care unit stay. Best Pract Res Clin Anaesthesiol. 2008; 22(4):669-94.
[37] Reynolds L, Beckmann J, Kurz A. Perioperative complications of hypothermia. Best Pract Res Clin Anaesthesiol. 2008; 22(4):645-57.
[38] Fenta E, Kibret S, Hunie M, Tamire T, Fentie Y, Seid S, et al. The effects of intravenous tramadol vs. intravenous ketamine in the prevention of shivering during spinal anesthesia: A meta-analysis of randomized controlled trials. Front Med (Lausanne). 2022; 9:1011953.
[39] Kiekkas P, Poulopoulou M, Papahatzi A, Souleles P. Effects of hypothermia and shivering on standard PACU monitoring of patients. AANA journal. 2005; 73(1):47.
[40] Davis AJ, Bissonnette B. Thermal regulation and mild intraoperative hypothermia. Curr Opin Anaesthesiol. 1999; 12(3):303-9.
[41] Zhou Y, Mannan A, Han Y, Liu H, Guan HL, Gao X, Dai MS, Cao JL. Efficacy and safety of prophylactic use of ketamine for prevention of postanesthetic shivering: a systematic review and meta-analysis. BMC Anesthesiol. 2019; 19(1):245.
[42] Faraz A, Islam H, Jahangir M, Ashfaq F. Comparing The Effects of Low Doses of Ketamine and Tramadol In The Prevention Of Post-Spinal Anesthesia Shivering In Cesarean Section. Biological and Clinical Sciences Research Journal. 2023; 4(1).
[43] Islam MR, Karim M, Haque AMZ. Examination of Three Distinct Dosages of Dexmedetomidine for Counteraction of Postspinal Sedation Shivering in Transurethral Resection of Prostate (TURP) Medical Procedure. EAS Journal of Anaesthesiology and Critical Care. 2022; 4(4).
[44] Morsali SF, Movasseghi G, Kiaee MM, Ghorbanloo M, Mohaghegh MR, Morsali A, et al. Clonidine versus tramadol for postanesthetic shivering: A randomized clinical trial study. Biomedical Research and Therapy. 2017;4(10):1716-32.
[45] Saheban Maleki M, Sedaghati Ansari S, Rezaniazave F, Talai A. Comparing Intravenous Dexamethasone, Pethidine, and Ketamine for Postoperative Shivering Prevention in Patients Undergoing General Anesthesia. Internal Medicine Today. 2021;27(3):288-301.
[46] Morgan CJ, Curran HV, Drugs ISCo. Ketamine use: a review. Addiction. 2012; 107(1).
[47] Mazzeffi M, Johnson K, Paciullo C. Ketamine in adult cardiac surgery and the cardiac surgery intensive care unit: an evidence-based clinical review. Ann Card Anaesth. 2015; 18(2):202-9.
[48] Hudetz J, Iqbal Z, Gandhi S, Patterson K, Byrne A, Hudetz A, et al. Ketamine attenuates post‐operative cognitive dysfunction after cardiac surgery. Acta Anaesthesiologica Scandinavica. 2009; 53(7):864-72.
[49] Hovaguimian F, Tschopp C, Beck‐Schimmer B, Puhan M. Intraoperative ketamine administration to prevent delirium or postoperative cognitive dysfunction: A systematic review and meta‐analysis. Acta Anaesthesiol Scand. 2018; 62(9):1182-93.
[50] Sarshivi F, Ghaderi E, Sarshivi A, Shami S, Nasseri K. Intravenous ketamine for the prevention of post anesthetic shivering in spinal anesthesia: A randomized double-blind placebo-controlled trial. Acta Medica Iranica. 2020; 58(10):479-85.
[51] Thangavelu R, George SK, Kandasamy R. Prophylactic low dose ketamine infusion for prevention of shivering during spinal anesthesia: A randomized double-blind clinical trial. J Anaesthesiol Clin Pharmacol. 2020; 36(4):506-510.
[52] Seyam SH. Prevention of post-spinal anesthesia shivering: Low dose ketamine vs tramadol. Al-Azhar International Medical Journal. 2020;1(4):108-15.
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How to Cite
1.
Sangi S, Mesbah Kiaei M, Sedigh Maroufi S, Aligholizadeh M, Moradimajd P, Saei A. Shivering Management in Spinal Anesthesia: Evaluating the Role of Ketamine: A Narrative Review. Arch Anesth & Crit Care. 2024;.
