title: 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.
  
  
  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.affiliation: Department of Anesthesiology, Guizhou Medical University, Guiyang, Guizhou, China (mainland).
authors.forename: Lin Shao
authors.initials: LS
authors.lastname: Feng
authors.affiliation: Department of Anesthesiology, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China (mainland).
authors.forename: Gao
authors.initials: G
authors.lastname: Hong
authors.affiliation: Department of Anesthesiology, The First People's Hospital of Guiyang, Guiyang, Guizhou, China (mainland).
authors.forename: Zhao
authors.initials: Z
authors.lastname: Yan
authors.affiliation: Department of Anesthesiology, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China (mainland).
authors.forename: Liu Yan
authors.initials: LY
authors.lastname: Qiu
authors.affiliation: Department of Anesthesiology, Guizhou Medical University, Guiyang, Guizhou, China (mainland).
authors.forename: Li An
authors.initials: LA
authors.lastname: Liang
mesh_terms: D000758:Anesthesia; D001919:Bradycardia / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007022:Hypotension / Q000453:epidemiology / Q000209:etiology; D015994:Incidence; D007278:Injections, Spinal / Q000009:adverse effects; D010919:Placebos; D011537:Pruritus / Q000453:epidemiology / Q000209:etiology; D012768:Shivering / Q000187:drug effects*; D017409:Sufentanil / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology*; D014839:Vomiting / Q000453:epidemiology / Q000209:etiology
chemical_list: D010919:Placebos; D017409:Sufentanil