COMPARATIVE STUDY BETWEEN MEPERIDINE, KETAMINE, AND ONDASETRON FOR PROPHYLACTIC MANAGEMENT OF POST-SPINAL SHIVERING IN PATIENTS UNDERGOING LOWER ABDOMINAL SURGERIES

Abstract

Background: Shivering can be very unpleasant and physiologically stressful for the patient. It can be detrimental to patients with low cardio-respiratory reserve. Objective: The study was done to compare the effect of Meperidine, Ketamine, and Ondansetron in prevention of post-spinal shivering. Patients and Methods: This prospective randomized single blinded controlled clinical study was conducted on 120 patients under spinal anesthesia ASA I, II, undergoing lower abdominal and lower limb surgical procedures not exceeding 60 minutes. Patients were randomized into three equal groups. Group (A) received meperidine in a dose of 0.5 mg/kg.i.v, Group(B) received ketamine in a dose of 0.25 mg/kg.iv, and Group (C) received ondansetron in a dose of 4 mg. iv . All these drugs were given after subarachnoid block. Patients were evaluated by measuring shivering grade, HR, Systolic BP every 5 minutes for 60 minutes after interthecal injection. Shivering during spinal anesthesia was determindeded using a scale validated by Tsai and Chu. Blood pressure, heart rate and side effects were recorded. Results: There were statistical significant differences between Meperidine, Ketamine, and Ondansetron as Meperidine has a superior effect in prevention of shivering. No changes in systolic BP and HR. Conclusion: Meperidine and low dose ketamine (0.25mg/kg) were significantly more effective than ondansetron for prevention of post-spinal shivering in patients undergoing lower abdominal surgeries.