Controlling shivering is of paramount importance and should begin with nonpharmacologic measures : apply surface counterwarming to the patient’s face, hands, and feet. If this is ineffective, quickly proceed to more aggressive pharmacologic interventions as prescribed. Meperidine, an opioid, is often the drug of choice to reduce shivering; its antishivering effects may be enhanced by concurrent administration of buspirone or dexmedetomidine. A magnesium sulfate infusion causes vasodilation and can decrease shivering. Propofol can also reduce shivering by decreasing vasoconstriction. If these drugs are ineffective, neuromuscular blockers such as vecuronium may be prescribed to inhibit the vasomotor response to the shivering reflex elicited in the central nervous system