Journal of Research in Pharmacy Practice

Intrathecal Meperidine versus intrathecal Fentanyl for prevention of shivering in lower limb orthopedic surgeries under spinal anesthesia: A randomized double-blind placebo-controlled trial

Document Type : Original Article

Authors

. Mohammadreza Safavi
. Azim Honarmand
. Elahe Rahmanikhah
. Sajad Badiei
. Mohammadali Attari

Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract
Objective: Shivering is an unpleasant sensation for patients who undergoing spinal 
anesthesia. This randomized double‑blind clinical trial study was designed to compare the 
effect of intrathecal fentanyl with intrathecal meperidine for prevention of shivering in lower 
limb orthopedic surgeries under spinal anesthesia.
Methods: Ninety patients were randomly recruited to receive either 3 ml of 0.5% hyperbaric 
bupivacaine plus 20 μg of fentanyl (Group F), or 3 ml of 0.5% hyperbaric bupivacaine plus 
0.2 mg/kg of meperidine (Group M), or 3 ml of 0.5% hyperbaric bupivacaine plus normal saline 
(Group S). The incidence and intensity of shivering were compared in three groups. Data 
were analyzed by analysis of variances, Mann–Whitney U‑test followed by Chi‑square test.
Findings: There were not statistically differences in complications and side‑effects between 
three groups. Total incidence of shivering was similar between Groups F and M (16.7% 
vs. 13.3% respectively, P = 0.72) whereas it was significantly different to Group S (43.3%) 
(P = 0.025 for Group F vs. S, and P = 0.011 for Group M vs. S). Also the intensity of 
shivering between Groups F and M was similar (P = 0.66), while it was significantly less in 
these groups compared to Group S (P = 0.013 and P = 0.004, respectively).
Conclusion: Addition of fentanyl 20 µg or meperidine 0.2 mg/kg to 0.5% bupivacaine 
intrathecally significantly decreased the incidence of shivering in lower limb orthopedic 
surgeries. There was no significant difference between two drugs with this respect.

Keywords

Fentanyl
intrathecal
Meperidine
shivering
spinal anesthesia
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Journal of Research in Pharmacy Practice
Volume 3, Issue 4
Autumn 2014
Pages 137-141

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