{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T15:25:18Z","timestamp":1782487518315,"version":"3.54.5"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,12,5]],"date-time":"2022-12-05T00:00:00Z","timestamp":1670198400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Shivering is a common complication after subarachnoid administration of local anesthetics. Intravenous ketamine and tramadol are widely available anti-shivering drugs, especially in developing settings. This meta-analysis aimed to compare the effects of intravenous ketamine vs. tramadol for post-spinal anesthesia shivering.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>PubMed\/MEDLINE, Web of Science, Cochrane Library, Embase, and Google Scholar databases were used to search for relevant articles for this study. Mean difference (MD) with 95% confidence interval (CI) was used to analyze continuous outcomes, and risk ratio (RR) with 95% CI to analyze categorical results. The heterogeneity of the included studies was assessed using the I2 test. We utilized Review Manager 5.4.1 to perform statistical analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirteen studies involving 1,532 patients were included in this meta-analysis. Ketamine had comparable effects in preventing post-spinal anesthetics shivering [RR = 1.06; 95% CI (0.94, 1.20), <jats:italic>P<\/jats:italic> = 0.33, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> = 77], and onset of shivering [MD = \u22120.10; 95%CI (\u2013 2.68, 2.48), <jats:italic>P<\/jats:italic> = 0.94, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> = 0%], lower incidences of nausea and vomiting [RR = 0.51; 95%CI (0.26, 0.99), <jats:italic>P<\/jats:italic> = 0.05, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> = 67%], and lower incidences of bradycardia [RR = 0.16; 95%CI (0.05, 0.47), <jats:italic>P<\/jats:italic> = 0.001, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> = 33%], higher incidence of hallucinations [RR = 12; 95%CI (1.58, 91.40), <jats:italic>P<\/jats:italic> = 0.02, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> = 0%], and comparable effects regarding the incidences of hypotension [RR = 0.60; 95%CI (0.30, 1.21), <jats:italic>P<\/jats:italic> = 0.15, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> = 54%] as compared to tramadol.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Intravenous ketamine and tramadol are comparable in the prevention of post-spinal anesthetic shivering. Ketamine had a better outcome with less occurrences of nausea, vomiting, and bradycardia. However, ketamine was associated with higher incidences of hallucinations than tramadol.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2022.1011953","type":"journal-article","created":{"date-parts":[[2022,12,5]],"date-time":"2022-12-05T05:36:55Z","timestamp":1670218615000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["The effects of intravenous tramadol vs. intravenous ketamine in the prevention of shivering during spinal anesthesia: A meta-analysis of randomized controlled 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