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Background and Aims Shivering is known to be a frequent complication in patients undergoing surgery under neuraxial anesthesia with incidence of 40–70% Although many pharmacological agents have been used to treat or prevent postspinal anesthesia shivering (PSAS), the ideal treatment wasn’t found.[1] This study compared the effects of remimazolam with propofol on postoperative shivering(PS) in patients undergoing cesarean section under spinal anesthesia.

Methods Seventy patients were allocated into one of two groups. After delivery, group A received propofol and group B received remimazolam for sedation.

Results The incidence and severity of postoperative shivering, core body temperature, and the association of PS with hypothermia, MAP, or HR in the post-anesthesia care unit (PACU) were measured. Group B had significantly lower rates of perioperative hypothermia (50.1 vs. 28.0%, p = 0.04) and postoperative shivering (40.2 vs. 20.1%, p = 0.042). The severity of PS was also lower in group B than in group A (p = 0.032). Core body temperature was significantly higher in group B than in group A from 10 min after induction (p = 0.046) to the PACU (p = 0.02). MAP and HR were more stable in group B than in group A. In group A, the correlation between the severity of PS and the incidence of hypothermia was moderate but not significant. In group B, the correlation between PS severity and hypothermia was moderate and significant.

Conclusions Remimazolam showed better results than propofol in anesthesia maintenance regarding hypothermia.