Background and Goal of Study: Postoperative shivering is a common uncomfortable post-anesthetic side effect. There was still debate whether postoperative shivering was more developed after general anesthesia with remifentanil compared with other opioid analgesics. There is insufficient published paper on the incidence of sufentanil-related postoperative shivering. We hypothesized that sufentanil would not increase the incidence of postoperative shivering than remifentanil. Therefore, we investigated the incidence of postoperative shivering related with either sufentanil or remifentanil in patients underwent elective surgery. 

Materials and Methods: After Institutional Review Board approval, patients, aged between 20 to 65 years old, ASA I or II, were enrolled. We excluded the patients with preoperative hypothermia, endocrine disease, and thyroid disease. eighty-six patients were randomly allocated to one of two groups. They received propofol and either remifentanil (group RP, n=40) or sufentanil (group SP, n=43) with a target site concentration infusion device. The infusion rates of propofol and remifentanil was adjusted to maintain the 40-60 of bispectral index score and within ± 20% of mean blood pressure. After anesthesia induction, the core body temperature and the tympanic membrane temperature were recorded at 30 minutes after induction of anesthesia and the end of surgery. For one hour after the recovery room entrance, the incidence and degree of postoperative shivering were evaluated using a table defined it in four steps. All values were presented as mean (95% confidential intervals) or number of patients (%). The statistical analysis was performed by t-test, or the χ2 test. P < 0.05 was considered to indicate statistical significance. 

Results and Discussion: The incidence of postoperative shivering was not significantly different between group RP (15%) and SP (11.6%) (P = 0.694). There were no significant differences in the core body temperature and tympanic membrane temperature between group RP and SP. 

Conclusion: The total intravenous anesthesia with sufentanil induces the similar incidence of postoperative shivering compared with remifentanil. However, even though there was non-significant difference, total intravenous anesthesia with sufentanil seems to be effective to reduce the postoperative shivering than remifentanil.

The total intravenous anesthesia with sufentanil induces the similar incidence of postoperative shivering compared with remifentanil. A prospective, double-blinded, randomized control study