Perioperative administration of dexamethasone to prevent postoperative shivering: a systematic review and meta-analysis of randomized controlled trials

Abstract

Objective To evaluate the perioperative administration of dexamethasone to prevent postoperative shivering. Methods We searched PubMed, Embase, Google Scholar, Web of Science, and Cochrane Library for relevant studies of the administration of dexamethasone to prevent postoperative shivering published through 31 May 2023. The primary outcome was the incidence of postoperative shivering. Secondary outcomes comprised the incidence of postoperative nausea, vomiting, and postoperative nausea and vomiting (PONV). RevMan 5.3 software was used for the data analysis. Results We included 12 randomized controlled trials (1276 participants). The results revealed a benefit favoring the perioperative administration of dexamethasone to prevent postoperative shivering (relative risk [RR]: 0.39; 95% confidence interval [CI]: 0.23–0.63), as well as the grade of shivering. The administration of dexamethasone also reduced the incidence of postoperative nausea (RR: 0.54; 95% CI: 0.39–0.73), postoperative vomiting (RR: 0.37; 95% CI: 0.20–0.65), and PONV (RR: 0.50; 95% CI: 0.26–0.95) compared with the control group. Conclusion This study indicated that perioperative administration of dexamethasone prevented postoperative shivering and decreased the incidence of other complications. PROSPERO registration number: CRD42020164488.