Prophylactic efficacy of oral gabapentin on postoperative shivering A meta-analysis of randomized controlled trials

Background: Postoperative shivering may lead to severe side effects during postoperative care, particularly in patients with impaired cardiopulmonary function. The efficacy of oral gabapentin as a preventive strategy for postoperative shivering has not been quantitatively analyzed. In this meta-analysis, we aimed to evaluate the effectiveness of gabapentin as a drug for treating postoperative shivering. Methods: A review of the Cochrane Library, PubMed, and Embase was conducted by 2 researchers for randomized controlled trials (RCTs). In this meta-analysis, Review Manager was used to analyze these RCTs on oral gabapentin for postoperative shivering. Results: Six trials with 544 patients were included in our meta-analysis. Prophylactic oral gabapentin reduced postoperative shivering compared with placebo (pooled risk ratio [RR]: 0.38, 95% confidence interval [CI]: 0.25-0.57). The anti-shivering effect could be achieved after both general anesthesia (pooled RR of 3 trails: 0.28, 95% CI: 0.14-0.56) and orthopedic surgery (pooled RR of 4 trails: 0.38, 95% CI: 0.24-0.58). Meanwhile, gabapentin also could decrease postoperative vomiting (POV; pooled RR 0.35, 95% CI 0.16-0.77). Conclusion: Our current meta-analysis shows that compared with placebo, oral gabapentin can reduce the incidence of postoperative shivering. This result also provides new evidence to strengthen the clinical application value of gabapentin in the conventional treatment of POV.