Treatment of Postoperative Shivering with Dexamethasone: A Prospective Randomized Clinical Trial

Background: Postoperative shivering is an important and troublesome condition during recovery from general anesthesia.  Corticosteroids have been recommended to facilitate recovery and diminish shivering after cardiac surgery.  Previous studies recommended 0.6 mg/kg dexamethasone for reducing postoperative shivering in patients undergoing cardiac surgery.   Objective: To test this assertion, we administered 0.15 mg/kg dexamethasone to patients undergoing routine surgeries, e.g., laparotomy, thoracotomy, and orthopedic, urologic and gynecological operations. Methods: A total of 200 patients undergoing elective operations were randomly selected and divided into two groups.  To the first group 0.15 mg/kg dexamethasone and to the control group, a placebo was injected right after the induction of anesthesia and before making any skin incision.  Patients did not have any coexisting diseases, e.g., diabetes, hypertension, ischemic heart disease, etc., nor were they on any specific medication.  All patients received the same doses of diazepam, morphine, sodium thiopental, 50% O2, 50% N2O, and 0.5% halothane for the induction and maintenance of general anesthesia. Results: Patients who had received dexamethasone had a significantly (p<0.001) lower incidence of postoperative shivering (12%) compared to the control group receiving placebo (31%).  Conclusion: Small doses of dexamethasone (0.15 mg/kg) could effectively decrease the incidence of postoperative shivering.