The effect of intrathecal pethidine on Post-Spinal anesthesia shivering after cesarean section: a systematic review and Meta-Analysis

Spinal anesthesia is the most preferred method for cesarean section (C-section). This meta-analysis was performed to determine the effect low and high intrathecal doses of pethidine on the maternal outcomes after C-section. A systematic search of PubMed, Scopus, Cochrane Library, and Google Scholar was performed. Random-effects meta-analysis was performed to derive odds ratios (ORs) from dichotomous data. Seventeen randomized controlled trials with 1,304 C-section patients were included. Patients who had received intrathecal pethidine experienced decreased shivering and intensity of shivering (OR 0.13; P<0.001) and (OR 0.21; P<0.001), respectively. Moreover, vomiting (OR 2.47; P=0.002) and pruritus (OR 5.92; P<0.001) were significantly higher in the pethidine group. There was no statistically significant difference in incidence of nausea (OR 2.55; P=0.06) and hypotension (OR 0.91; P=0.67). Intrathecal pethidine can effectively decrease shivering, though it increases the risk of vomiting and pruritus. No significant difference was found both in the maternal hypotension and nausea.