Involvement of serotonergic pathways in postanaesthetic cold defence: Dolasetron prevents shivering

Serotonin is regarded as an essential neurotransmitter in thermoregulation. We evaluated the influence of the serotonergic antagonist dolasetron on thermoregulation and postanaesthetic shivering in mildly hypothermic patients in a randomised placebo-controlled study. The incidence of shivering was 24% after dolasetron compared to 69% after placebo (p<0.01). During the first 80 min postoperatively, core temperature remained lower in the treatment group (p<0.05). After dolasetron, 20% of the patients experienced thermal discomfort compared to 54% after placebo (p<0.05). Serotonin antagonism seems to lower the human thermal set-range thereby reducing metabolic cold defence and discomfort associated with postoperative hypothermia.