{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T15:54:02Z","timestamp":1783180442264,"version":"3.54.6"},"reference-count":24,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,8,3]],"date-time":"2022-08-03T00:00:00Z","timestamp":1659484800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Shivering is a common complication of subarachnoid block (SAB). Magnesium sulphate has been proven to be effective in preventing shivering. The aim of this study was to compare the effectiveness and adverse effects in hemodynamic parameters between 50 mg\/kg and 30 mg\/kg of intravenous magnesium sulphate for prevention of shivering post-subarachnoid block. Materials and Methods: Eighty-six patients scheduled for surgery under SAB, aged between 18 to 65 years old with American Society of Anesthesiologists physical status I and II were randomised into two groups. Group A received a bolus of 50 mg\/kg, while Group B received 30 mg\/kg of intravenous magnesium sulphate, given over a 20 min duration following SAB. Shivering grade was recorded intraoperatively according to the Crossley and Mahajan shivering scale. Mean arterial pressure (MAP), heart rate, tympanic temperature, oxygen saturation and the use of vasopressors were recorded. Results: Forty-five percent of patients in Group A and 20% of patients in Group B did not exhibit shivering (p-value &lt; 0.01). High-grade shivering was observed in 12.5% in Group A and 40% in Group B, respectively (p-value 0.02). The MAP trend was lower in Group B (p-value &lt; 0.01), but the incidence of hypotension was not significant in both groups. The use of vasopressors was also similar between groups. Group B showed a lower oxygen saturation trend (p-value 0.04). The trends of heart rate and tympanic temperature were not significant in both groups. No patients had episodes of bradycardia or oxygen desaturation. Conclusions: In this study, intravenous magnesium sulphate 50 mg\/kg is the lowest effective dose for prevention and treatment of high-grade shivering post-SAB without significant hemodynamic adverse events.<\/jats:p>","DOI":"10.3390\/medicina58081046","type":"journal-article","created":{"date-parts":[[2022,8,3]],"date-time":"2022-08-03T23:33:01Z","timestamp":1659569581000},"page":"1046","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Prevention of Shivering Post Subarachnoid Block: Comparison between Different Doses of Intravenous Magnesium Sulphate"],"prefix":"10.3390","volume":"58","author":[{"given":"Ren Geng","family":"Low","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azarinah","family":"Izaham","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaafar Md","family":"Zain","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadia Md","family":"Nor","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsueh Jing","family":"Low","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3494-3010","authenticated-orcid":false,"given":"Aliza Mohamad","family":"Yusof","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"242","DOI":"10.4103\/0019-5049.82666","article-title":"A comparative study of the effect of clonidine and tramadol on post-spinal anaesthesia shivering","volume":"55","author":"Shukla","year":"2011","journal-title":"Indian J. Anaesth."},{"key":"ref_2","first-page":"73","article-title":"Postanaesthetic shivering\u2014From pathophysiology to prevention","volume":"25","author":"Lopez","year":"2018","journal-title":"Rom. J. Anaesth. Intensive Care"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1097\/00000542-200202000-00036","article-title":"Perioperative shivering: Physiology and pharmacology","volume":"96","author":"Sessler","year":"2002","journal-title":"Anesthesiology"},{"key":"ref_4","first-page":"174","article-title":"Magnesium sulphate vsersus meperidine for prevention of shivering in patients scheduled for elective orthopedic surgery under spinal anesthesia","volume":"8","author":"Abdelrahman","year":"2010","journal-title":"AAMJ"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Luggya, T.S., Kabuye, R.N., Mijumbi, C., Tindimwebwa, J.B., and Kintu, A. (2016). Prevalence, associated factors and treatment of post spinal shivering in a Sub-Saharan tertiary hospital: A prospective observational study. BMC Anesthesiol., 16.","DOI":"10.1186\/s12871-016-0268-0"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1080\/22201173.2013.10872917","article-title":"Effectiveness of low-dose midazolam plus ketamine in the prevention of shivering during spinal anaesthesia for emergency lower limb surgery","volume":"19","author":"Misiran","year":"2013","journal-title":"S. Afr. J. Anaesth. Analg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2","DOI":"10.4103\/1658-354X.197344","article-title":"A comparative study on the efficacy of dexmedetomidine and tramadol on post-spinal anesthesia shivering","volume":"11","author":"Kundra","year":"2017","journal-title":"Saudi J. Anaesth."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"774","DOI":"10.1097\/00000542-199610000-00012","article-title":"Effects of motion on the performance of pulse oximeters in volunteers","volume":"85","author":"Barker","year":"1996","journal-title":"Anesthesiology"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1093\/bja\/79.4.541","article-title":"Comparison between alfentanil, pethidine and placebo in the treatment of post-anaesthetic shivering","volume":"79","author":"Wrench","year":"1997","journal-title":"Br. J. Anaesth."},{"key":"ref_10","first-page":"555646","article-title":"Magnesium Sulfate: A Versatile Anesthetic Adjuvant","volume":"4","author":"Shin","year":"2017","journal-title":"Anesth. Intensive Care"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1213\/ANE.0000000000004024","article-title":"Effectiveness of magnesium in preventing shivering in surgical patients: A systematic review and meta-analysis","volume":"129","author":"Kawakami","year":"2019","journal-title":"Anesth. Analg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1111\/j.1365-2044.1994.tb03422.x","article-title":"The intensity of postoperative shivering is unrelated to axillary temperature","volume":"49","author":"Crossley","year":"1994","journal-title":"Anaesthesia"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1016\/j.jclinane.2009.06.006","article-title":"Magnesium sulfate infusion prevents shivering during transurethral prostatectomy with spinal anesthesia: A randomized, double-blinded, controlled study","volume":"22","author":"Gozdemir","year":"2010","journal-title":"J. Clin. Anesth."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.egja.2013.07.007","article-title":"Prophylactic vs. therapeutic magnesium sulfate for shivering during spinal anesthesia","volume":"30","author":"Ibrahim","year":"2014","journal-title":"Egypt J. Anaesth."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2142","DOI":"10.21608\/ejhm.2019.30101","article-title":"Comparative study between dexmedetomidine, magnesium sulphate and meperidine as anti-shivering agent following neuraxial anesthesia","volume":"75","author":"Kasem","year":"2019","journal-title":"Egypt J. Hosp. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.egja.2013.03.002","article-title":"Is this the time for Magnesium sulfate to replace Meperidine as an antishivering agent in spinal anesthesia?","volume":"29","author":"Elsonbaty","year":"2013","journal-title":"Egypt J. Anaesth."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Tan, W., Qian, D.C., Zheng, M.M., Lu, X., Han, Y., and Qi, D.Y. (2019). Effects of different doses of magnesium sulphate on pneumoperitoneum-related hemodynamic changes in patients undergoing gastrointestinal laparoscopy: A randomized, double-blind, controlled trial. BMC Anesthesiol., 19.","DOI":"10.1186\/s12871-019-0886-4"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"130","DOI":"10.4103\/aer.AER_196_17","article-title":"Comparison of prophylactic intravenous magnesium sulfate with tramadol for postspinal shivering in elective cesarean section: A placebo controlled randomized double-blind pilot study","volume":"12","author":"Sachidananda","year":"2018","journal-title":"Anesth. Essays Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1093\/bja\/aep334","article-title":"IV infusion of magnesium sulphate during spinal anaesthesia improves postoperative analgesia","volume":"104","author":"Hwang","year":"2010","journal-title":"Br. J. Anaesth."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1289","DOI":"10.1016\/j.biopha.2018.09.157","article-title":"Effect of intravenous magnesium sulfate on bupivacaine spinal anesthesia in preeclamptic patients","volume":"108","author":"Zhong","year":"2018","journal-title":"Biomed. Pharmacother."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1093\/bja\/79.3.363","article-title":"Effects of magnesium sulphate on the cardiovascular system, coronary circulation and myocardial metabolism in anaesthetized dogs","volume":"79","author":"Nakaigawa","year":"1997","journal-title":"Br. J. Anaesth."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2395","DOI":"10.1001\/jama.1992.03490170067027","article-title":"Magnesium administration and dysrhythmias after cardiac surgery: A placebo-controlled, double-blind, randomized trial","volume":"268","author":"England","year":"1992","journal-title":"JAMA"},{"key":"ref_23","first-page":"267","article-title":"The Effect of Intravenous Magnesium Sulphate as an Adjuvant in the Treatment of Acute Exacerbations of COPD in the Emergency Department: A Double-Blind Randomized Clinical Trial","volume":"31","author":"Jahanian","year":"2021","journal-title":"Ethiop. J. Health Sci."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1016\/S0029-7844(97)00155-5","article-title":"Maternal oxygen desaturation with intravenous magnesium therapy","volume":"89","author":"Thorp","year":"1997","journal-title":"Obstet. Gynecol."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/8\/1046\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:03:46Z","timestamp":1760141026000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/8\/1046"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,3]]},"references-count":24,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2022,8]]}},"alternative-id":["medicina58081046"],"URL":"https:\/\/doi.org\/10.3390\/medicina58081046","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,3]]}}}