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Pethidine for postoperative shivering — FRCA Primary MCQ

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HardPharmacologyPethidine for postoperative shiveringFRCA Primary

A 50-year-old woman has severe postoperative shivering after volatile anaesthesia. Pethidine is considered. Which pharmacological property is most relevant to its anti-shivering effect?

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Correct answer: E — Kappa-opioid activity and alpha-2 related thermoregulatory effects

Pethidine has anti-shivering properties that are not explained by simple mu-opioid analgesia alone and involve kappa-opioid and thermoregulatory effects. NSAID-like cyclo-oxygenase inhibition is not the key mechanism. NMDA antagonism is more relevant to ketamine. The pearl is that shivering increases oxygen consumption and may matter in limited cardiopulmonary reserve.

Reference: RCoA Primary FRCA Syllabus 2026; Peck, Hill & Williams Pharmacology for Anaesthesia