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GENERAL ARTICLES

A Comparison Between Meperidine, Clonidine and Urapidil in the Treatment of Postanesthetic Shivering

Konrad R. G. Schwarzkopf, MD^*, Hansjoerg Hoff^*, Michael Hartmann, ScD, and Harald G. Fritz, MD^*

Departments of *Anesthesiology and Intensive Care Therapy, and Pharmacy, University Hospital, Jena, Germany

Address correspondence and reprint requests to Konrad R. G. Schwarzkopf, MD, Klinik fuer Anaesthesiologie und Intensivtherapie, Klinikum der Friedrich-Schiller-Universitaet, Bachstrasse 18, 07740 Jena, Germany.

Postanesthetic shivering can be treated with many types of drugs. We compared the effects of meperidine, clonidine, and urapidil on postanesthetic shivering. Sixty patients shivering during recovery from general anesthesia were treated in a randomized, double-blinded fashion with 25 mg meperidine IV, 0.15 mg clonidine IV, or 25 mg urapidil IV in three separate groups of 20 patients each. If shivering did not stop within 5 min, the treatment was repeated once; clonidine was replaced with saline for the second dose. Rectal temperature, arterial blood pressure, heart rate, SaO₂ and vigilance were monitored. Clonidine stopped shivering in all 20 patients. A single dose of meperidine stopped the shivering in 18 of 20 patients, with the other 2 patients needing a second dose. Urapidil was less effective: the first dose stopped the shivering in only six patients; the second dose was effective in another six; the drug was ineffective in 8 of 20 patients. Meperidine and clonidine were both nearly 100% effective in treating postanesthetic shivering without negative side effects. By comparison, urapidil was only effective in 60% of patients treated (P <0.01).

Implications: Patients shivering during recovery from general anesthesia were treated in a randomized double-blinded fashion with meperidine, clonidine, or urapidil. Meperidine and clonidine were both very effective, whereas urapidil was only effective in 60% of patients treated.

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