Journal of Research in Pharmacy Practice

Prophylactic effects of intrathecal Meperidine and intravenous Ondansetron on shivering in patients undergoing lower extremity orthopedic surgery under spinal anesthesia

Document Type : Original Article

Authors

. Mohammadreza Safavi
. Azim Honarmand
. Maryam Negahban
. Mohammadali Attari

Department of Anesthesia and Intensive Care Medicine, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract
Objective: Intraoperative hypothermia is a common problem with anesthesia. Spinal 
anesthesia, the same as general anesthesia, affects the process of temperature regulation. The 
aim of this study was to compare the prophylactic effect of intravenous(IV) ondansetron with 
intrathecal (IT) meperidine on prevention of shivering during spinal anesthesia in patients 
underwent orthopedic surgery of the lower limb.
Methods: In this study, 120 patients with American Society of Anesthesiologists physical 
status I to II, between the ages 16 and 65 were randomized into three groups. Group O 
and Group M were given IV ondansetron 8 mg and IT meperidine 0.2 mg/kg, before spinal 
anesthesia, respectively. Group C received IV saline 0.9%. The core and ambient temperatures, 
the incidence and intensity of shivering, blood pressure, heart rate, and maximum level of 
sensory block were recorded.
Findings: Shivering was observed in 15%, 2.5%, and 37.5% of patients in Groups O, M, and 
C, respectively. There was a significant difference between Group O and M compared to 
Group C (P = 0.023 for Group O vs. Group C, P < 0.001 for Group M vs. Group C, P = 0.049 
for Group M vs. Group O). Shivering incidence and intensity in Group M was significantly 
lower than Group O (P = 0.049 and P = 0.047, respectively). Twenty‑two patients required 
additional IV meperidine among which 15 patients were from Group C (37.5%), six patients 
from Group O (15%) and one patient from Group M (2.5%).
Conclusion: We concluded that IT meperidine and IV ondansetron comparably can 
decrease intensity and incidence of shivering compared to control group as well as decreasing 
the requirement to additional doses of meperidine for shivering the control without any 
hemodynamic side effect.

Keywords

Hypothermia
Meperidine
Ondansetron
orthopedic surgery
shivering
  spinal anesthesia

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Journal of Research in Pharmacy Practice
Volume 3, Issue 3
Summer 2014
Pages 94-99

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