Dexamethasone

Shivering
and Effects of Dexamethasone

   

• Yared
  JP, Starr NJ, Hoffman  HoggL, et al
  
  Dexamethasone
  Decreases the Incidence of Shivering After Cardiac
  Surgery : A Randomized, Double Blind, Placebo
  Controlled Study
  
  Anesth
  Analg 87: 795-799, 1998
  
  
   
  
  Many
  patients undergoing cardiac surgery experience
  shivering in the immediate postoperative period. A possible cause of this problem is fever and chills resulting from
  activation of the inflammatory response and release
  of cytokines by cardiopulmonary bypass [CPB].
  Because Dexamethasone [DEX] can modify the
  inflammatory response to CPB, prevent fever, and
  improve peripheral circulation, the drug has been
  recommended for use in cardiac surgery.
  
   
  
  The
  double blind study randomized 236 patients to DEX or
  placebo, administered after the induction of
  anesthesia but before skin incision.
  After surgery, ICU nurses unaware of the
  patient’s treatment group, recorded visible
  shivering. Skin
  temperatures and central blood temperature were
  monitored continuously and 02 consumption and CO2
  production were randomly minitored to confirm the
  nurses’ measurements.
  
   
  
  DEX
  significantly decreased the incidence of shivering
  from 33% to 13% in the 205 evaluable patients. The
  two treatment groups did not differ significantly in
  duration of anesthesia, CPB cross-clamp time, lowest
  bladder temperature on CPB, or central blood
  temperature on admission to ICU.
  The incidence of shivering was significantly
  lower in the DEX group, irrespective of whether CPB
  was with normothermia or hypothermia.
  Significantly 34 patients were women and none
  of them experienced any shivering.