SynthesisFrontiers in medicine2026
Efficacy and safety of ketamine and esketamine for the prevention of postanesthetic shivering in cesarean delivery: a systematic review and meta-analysis.
Synthesis in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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8 authors.
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Abstract
Purpose: Shivering is a common and undesirable complication associated with cesarean delivery under intrathecal anesthesia, which causes discomfort in patients and may interfere with vital signs monitoring. The main purpose of this meta-analysis was to evaluate the efficacy and safety of ketamine and esketamine for the prevention of postanesthetic shivering. Methods: We performed a systematic search of PubMed, Embase, Web of Science, CENTRAL, CNKI, and Wan Fang databases for randomized controlled trials (RCTs) evaluating the efficacy of ketamine and esketamine in preventing shivering in women undergoing cesarean delivery. The primary outcomes of this analysis were the incidence and the severity of postanesthetic shivering. Secondary outcomes were the incidence of adverse events. We integrated traditional meta-analysis with logistic regression to establish the dose-response relationships. Results: A total of 12 RCTs involving 1683 patients were included; most are assessed as low risk or with some concerns, and the quality of the evidence is mostly low and moderate. The incidence of postanesthetic shivering during cesarean delivery was significantly lower in the ketamine and esketamine (RR: 0.29; 95% CI: 0.20-0.42; Conclusion: Prophylactic application of ketamine and esketamine could be efficacious for reducing postanesthetic shivering during cesarean delivery. However, the dose-dependent increases in hallucination and nystagmus highlight the need to balance preventive efficacy against psychiatric adverse events when selecting the optimal dose. Additional convincing evidence is required to prove their value and safety in preventing shivering for obstetric patients. Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD420251076816.
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