Anesthesia & Clinical Research
Open Access

Abstract

Evidence Based Clinical Guideline on the Use of Ketamine for Management of Post-Anesthesia Shivering in Surgical Patients

Dugo Angasa*, Oliyad Eshetu, Fantahun Belay, Abebayehu Zemedkun, Markos Muka, Minda Abebe

Background: Post-anesthetic shivering is a common complication of anesthesia, which accounts for much discomfort in postoperative patients and may increase postoperative complications in high-risk patients. The main purpose of this review is systematically reviewing articles and finally drawing an evidence-based guideline for the use of ketamine for management of post-anesthetic shivering.

Materials and methods: Reporting Items for Practice Guidelines in Healthcare (RIGHT) process was followed in reporting the review. A literature search was conducted using the Hinari database, PubMed, Google Scholar and Cochrane review. Important words: Ketamine, anti-shivering, post-anesthetic shivering and shivering control were employed. Following the process of extracting and filtering results according to the interventions, outcome and methodological quality, two systematic reviews and meta-analyses, one observational study, sixteen randomised control trials and one outcome study were evaluated for quality. A determination was made regarding their degree of evidence and recommendation grade.

Conclusion: The majority of studies indicate that the low dose of ketamine, 0.25 mg/kg, is beneficial in treating postanesthetic shivering without resulting in any complications. However, a small number of studies suggest that, despite not causing any complications, the drug has dubious effectiveness in preventing post-anesthesia shivering following general anaesthesia and that lower doses appear to offer no benefit at all. Conversely, ketamine at a dose of 0.5 mg/kg shows greater results than a placebo and may even be just as effective as pethidine; nonetheless, adverse effects such as delirium and hallucinations have been recorded. To effectively manage post-anesthesia shivering and consequently prevent its recurrence, we advise using ketamine to treat or prevent it at doses of 0.15 mg/kg to 0.5 mg/kg.

Published Date: 2025-02-17; Received Date: 2024-06-06