TY - JOUR
T1 - Incidence of postoperative shivering comparing remifentanil with other opioids
T2 - a meta-analysis
AU - Hoshijima, Hiroshi
AU - Takeuchi, Risa
AU - Kuratani, Norifumi
AU - Nishizawa, Shuya
AU - Denawa, Yohei
AU - Shiga, Toshiya
AU - Nagasaka, Hiroshi
N1 - Publisher Copyright:
© 2015 Elsevier Inc.
PY - 2016/8/1
Y1 - 2016/8/1
N2 - Study Objective To determine whether the administration of remifentanil increases the incidence of postoperative shivering in comparison with the administration of alfentanil, fentanyl, or sufentanil. Design Meta-analysis. Setting Operating room and postanesthesia care unit. Measurements We performed a computerized search of articles on PubMed, MEDLINE, and Scopus. Meta-analysis was performed using Review Manager and the DerSimonian and Laird random-effects model. The pooled effect estimates for binary variables were calculated as relative risk (RR) values with 95% confidence intervals (CIs). Main Results Eighteen randomized controlled trials met our inclusion criteria. Remifentanil was associated with a significantly increased incidence of postoperative shivering compared with other opioids (RR = 2.17; CI, 1.76-2.68; P < .00001; I2 = 0.00%). A subgroup analysis of remifentanil compared with alfentanil, fentanyl, or sufentanil showed that only sufentanil had a similar rate of postoperative shivering incidence (RR = 2.13; CI, 0.67-6.74; P = .20; I2 = 0.00%). Remifentanil administration was associated with a significant increase in the incidence of postoperative shivering compared with the administration of other opioids when both propofol (RR = 2.44; CI, 1.52-3.92; P = .0002; I2 = 0.00%) and inhalation anesthesia drugs (RR = 2.45; CI, 1.46-4.11; P = .0007; I2 = 0.00%) were used for anesthesia maintenance. In addition, the administration of remifentanil at both low (RR = 2.06; CI, 1.63-2.60; P < .00001; I2 = 0.00%) and high dosages (RR = 2.77; CI, 1.67-4.57; P < .0001; I2 = 0.00%) was associated with a significant increase in the incidence of postoperative shivering compared with the administration of other opioids. Conclusions Our meta-analysis showed that remifentanil was associated with an increased incidence of postoperative shivering compared with alfentanil or fentanyl, but no significant difference was seen when compared with sufentanil.
AB - Study Objective To determine whether the administration of remifentanil increases the incidence of postoperative shivering in comparison with the administration of alfentanil, fentanyl, or sufentanil. Design Meta-analysis. Setting Operating room and postanesthesia care unit. Measurements We performed a computerized search of articles on PubMed, MEDLINE, and Scopus. Meta-analysis was performed using Review Manager and the DerSimonian and Laird random-effects model. The pooled effect estimates for binary variables were calculated as relative risk (RR) values with 95% confidence intervals (CIs). Main Results Eighteen randomized controlled trials met our inclusion criteria. Remifentanil was associated with a significantly increased incidence of postoperative shivering compared with other opioids (RR = 2.17; CI, 1.76-2.68; P < .00001; I2 = 0.00%). A subgroup analysis of remifentanil compared with alfentanil, fentanyl, or sufentanil showed that only sufentanil had a similar rate of postoperative shivering incidence (RR = 2.13; CI, 0.67-6.74; P = .20; I2 = 0.00%). Remifentanil administration was associated with a significant increase in the incidence of postoperative shivering compared with the administration of other opioids when both propofol (RR = 2.44; CI, 1.52-3.92; P = .0002; I2 = 0.00%) and inhalation anesthesia drugs (RR = 2.45; CI, 1.46-4.11; P = .0007; I2 = 0.00%) were used for anesthesia maintenance. In addition, the administration of remifentanil at both low (RR = 2.06; CI, 1.63-2.60; P < .00001; I2 = 0.00%) and high dosages (RR = 2.77; CI, 1.67-4.57; P < .0001; I2 = 0.00%) was associated with a significant increase in the incidence of postoperative shivering compared with the administration of other opioids. Conclusions Our meta-analysis showed that remifentanil was associated with an increased incidence of postoperative shivering compared with alfentanil or fentanyl, but no significant difference was seen when compared with sufentanil.
KW - Postoperative shivering
KW - Remifentanil
UR - http://www.scopus.com/inward/record.url?scp=84945582414&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84945582414&partnerID=8YFLogxK
U2 - 10.1016/j.jclinane.2015.08.017
DO - 10.1016/j.jclinane.2015.08.017
M3 - Review article
C2 - 26432635
AN - SCOPUS:84945582414
SN - 0952-8180
VL - 32
SP - 300
EP - 312
JO - Journal of Clinical Anesthesia
JF - Journal of Clinical Anesthesia
ER -