title: Nefopam for the prevention of perioperative shivering: a meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  Shivering is a frequent complication following surgery and anaesthesia. A large variety of studies have been reported that nefopam may be efficacious for the prevention and treatment of perioperative shivering. Regrettably, there is still no conclusion of the efficacy and safety of nefopam for the prevention of perioperative shivering. The aim of this analysis is to evaluate the efficacy of nefopam for the prevention of perioperative shivering in patients undergoing different types of anaesthesia compared with placebo group and other active interventions.
  
  
  METHODS
  PubMed, EMBASE, Cochrane Central Register of Control Trials were systematically searched for potentially relevant trials. Trial quality and extracted data were evaluated by two authors independently. Dichotomous data on the absence of shivering was extracted and analysed by using relative risk (RR) with 95% confidence interval (CI). Continuous outcome was abstracted and analysed by using weighted mean difference (WMD) with 95% confidence interval (CI). Outcome data was analysed by using random effect model or fixed effect model in accordance with heterogeneity.
  
  
  RESULTS
  Compared with placebo, prophylactic administration of nefopam significantly reduced the risk of perioperative shivering not only in the patients under general anaesthesia but also neuraxial anaesthesia (RR 0.08; 95% CI 0.05-0.13). As compared with clonidine, nefopam was more efficacious in the prevention of perioperative shivering (RR 0.34; 95% CI 0.17-0.70). Nefopam has no influence on the extubation time (WMD 0.92; 95% CI -0.15-1.99).
  
  
  CONCLUSIONS
  Our analysis has demonstrated that nefopam is associated with the decrease of risk of perioperative shivering following anaesthesia without influencing the extubation time.
authors.affiliation: Department of anesthesiology, Qianfo shan Hospital, Shandong University, Jinan, Shandong, China. qylvmeng@163.com.
authors.forename: Meng
authors.initials: M
authors.lastname: Lv
authors.affiliation: Department of anesthesiology, The Second affiliated hospital of Shandong Traditional Chinese Medicine University, Jinan, Shandong, China. taoxuewang882@vip.sina.com.
authors.forename: Xuetao
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of nosocomial infection management, the Central Hospital of Taian, Taian, Shandong, China. wendongqu@163.com.
authors.forename: Wendong
authors.initials: W
authors.lastname: Qu
authors.affiliation: Department of anesthesiology, Qianfo shan Hospital, Shandong University, Jinan, Shandong, China. liumengjie31@163.com.
authors.forename: Mengjie
authors.initials: M
authors.lastname: Liu
authors.affiliation: Department of anesthesiology, Qianfo shan Hospital, Shandong University, Jinan, Shandong, China. wyldgf@163.com.
authors.forename: Yuelan
authors.initials: Y
authors.lastname: Wang
mesh_terms: D018712:Analgesics, Non-Narcotic / Q000009:adverse effects / Q000627:therapeutic use; D000758:Anesthesia / Q000009:adverse effects / Q000379:methods; D003000:Clonidine / Q000627:therapeutic use; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control*; D009340:Nefopam / Q000009:adverse effects / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D012768:Shivering / Q000187:drug effects*
chemical_list: D018712:Analgesics, Non-Narcotic; D009340:Nefopam; D003000:Clonidine