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Shiver Me Timbers: Magnesium and Postoperative Shivering

Wanderer, Jonathan P. MD, MPhil; Nathan, Naveen MD

doi: 10.1213/ANE.0000000000004353
Infographics: Infographic

Vanderbilt University School of Medicine (

Northwestern University Feinberg School of Medicine (

Published ahead of print 26 June 2019.

The Infographic is composed by Jonathan P. Wanderer, MD, MPhil, Vanderbilt University School of Medicine (, and Naveen Nathan, MD, Northwestern University Feinberg School of Medicine ( Illustration by Naveen Nathan, MD.

The authors declare no conflicts of interest.

Postoperative shivering is a common occurrence following general anesthesia, which carries with it risk of poor patient experience and myocardial ischemia due to increased energy demands from muscular contractions. Magnesium has been evaluated as a medication to reduce the risk of postoperative shivering, administered through a variety of routes, although there has not yet been a meta-analysis and systematic review evaluating the data across all available clinical trials on its efficacy. In this infographic, we review the results of such an analysis and provide the available detail on dosing routes and regimens that can be utilized for the reduction of postoperative shivering.

CI indicates confidence interval; PONV, postoperative nausea and vomiting.

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1. Kawakami H, Nakajima D, Mihara T, Sato H, Goto T. Effectiveness of magnesium in preventing shivering in surgical patients: a systematic review and meta-analysis. Anesth Analg. 2019;129:689–700.
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