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Review
. 2024 Jul 22;86(9):5461-5470.
doi: 10.1097/MS9.0000000000002354. eCollection 2024 Sep.

The effect of intrathecal pethidine on post-spinal anesthesia shivering after cesarean section: a systematic review and meta-analysis

Muhammad Afzal  1 , Amber Lee  2 , Muhammad Asad  3 , Alya Ali  4 , Ameer Mustafa Farrukh  5 , Bader Semakieh  2 , Yaxel Levin-Carrion  6 , Shah Rukh Shah  7 , Qaisar Ali Khan  8
Affiliations
Review

The effect of intrathecal pethidine on post-spinal anesthesia shivering after cesarean section: a systematic review and meta-analysis

Muhammad Afzal et al. Ann Med Surg (Lond). .

Abstract

Background: Spinal anesthesia is the most preferred method for cesarean section (C-section). This meta-analysis was performed to determine the effect of low and high intrathecal doses of pethidine on the maternal outcomes after C-section.

Methods: A systematic search of PubMed, Scopus, Cochrane Library, and Google Scholar was performed. Random-effects meta-analysis was performed to derive odds ratios (ORs) from dichotomous data.

Results: Seventeen randomized controlled trials with 1304 C-section patients were included. Patients who had received intrathecal pethidine experienced decreased shivering and intensity of shivering (OR 0.13; P<0.001) and (OR 0.21; P<0.001), respectively. Moreover, vomiting (OR 2.47; P=0.002) and pruritus (OR 5.92; P<0.001) were significantly higher in the pethidine group. There was no statistically significant difference in the incidence of nausea (OR 2.55; P=0.06) and hypotension (OR 0.91; P=0.67).

Conclusions: Intrathecal pethidine can effectively decrease shivering, although it increases the risk of vomiting and pruritus. No significant difference was found both in the maternal hypotension and nausea.

Keywords: cesarean section; pethidine; spinal anesthesia; surgical complications.

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Conflict of interest statement

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) flowchart.
Figure 2
Figure 2
Forest plot of incidence of shivering.
Figure 3
Figure 3
Forest plot of intensity of shivering.
Figure 4
Figure 4
Forest plot of incidence of pruritus.
Figure 5
Figure 5
Forest plot of incidence of nausea.
Figure 6
Figure 6
Forest plot of incidence of vomiting.
Figure 7
Figure 7
Forest plot of incidence of hypotension.
See this image and copyright information in PMC

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