Shivering control in women under spinal anesthesia: A narrative review on the role of drugs

Document Type : Review Article


1 Assistant professor, Department of Anesthesiology and Critical Care, Anesthesiology & Critical Care and Pain Management Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.

2 Assistant professor, Department of Obstetrics and Gynecology, Women's Health and Diseases Research Center, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.

3 M.Sc. of Neonatal Intensive Care, Hazrate Fatemeh School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.

4 Assistant professor, Department of Surgery, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.

5 Assistant professor, Department of Emergency Medicine, Jahrom University of Medical sciences, Jahrom, Iran.

6 Assistant Professor, Department of Pharmacology, Faculty of Medicine, Guilan University of Medical Sciences, Guilan, Iran.

7 Instructor, Department of Anesthesia, Research Center for Social Determinants of Health, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.

8 Medical Student, Student Research Committee, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.

9 Assistant Professor, Department of Anesthesiology and Critical Care, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.


Introduction: Prevention and control of maternal shivering during spinal anesthesia for cesarean section is very important in the appropriate outcomes of surgery; however, choosing the appropriate drug for this issue should be associated with few side effects for mother and baby. Therefore, this study was performed with aim to evaluate the drugs used to control shivering in women under spinal anesthesia.
Methods: In this narrative review study, to find the related studies, computer search was performed in databases of SID, Magiran and Google Scholar with Persian keywords of spinal anesthesia, shivering and cesarean section. In the initial stage of searching, 364 studies were reviewed and 341 studies were deleted due to not being related to the subject. Finally, 13 studies were used to write this study.
Results: In reviewing the research background, different studies had used different drugs to prevent shivering after cesarean section. Shivering after spinal anesthesia has been the specific goal of many studies with clinical trial design. Performed interventions in this regard included: intrathecal or intravenous injection of drugs such as magnesium sulfate, hydrocortisone, dexamethasone, ondansetron, ketamine, midazolam, ketamine with midazolam. Opioid drugs such as fentanyl, tramadol, and pethidine have also been reviewed in some studies.
Conclusion: Based on various studies, pethidine with unknown and possible mechanism of μ receptors seems to be the best drug in control of Shivering in cesarean section.


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