Document Type : Original Article
Authors
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
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