Comparison the Efficacy of Ketamine on the Patients Undergoing Elective Surgery for Prevention of Postoperative Shivering

Abstract

Introduction: Patients frequently suffer from shivering following surgery. The shivering experienced by the patients may be a natural, thermal regulatory response to central hypothermia or as a result of the release of cytokines during the surgical process. This is unpleasant and occurs following surgery in 30-65% of patients who have received general anesthetics. Shivering increases the muscular activity, O2 consumption, CO2 production and may result in hypoxaemia, hypercarbia and lactic acidosis. It is not only uncomfortable but also cold sensation which is even worse feeling than pain sensation. Objective: To assess the Comparison the efficacy of ketamine on the patients undergoing elective surgery for prevention of postoperative shivering. Material & Methods: In this prospective study was conduct at the dept. of Anaesthesia, Shaheed Tajuddin Ahmad Medical College Hospital, Gazipur, Bangladesh from January to June-2021. Fifty (50) patients included in our study. The inclusion criteria were women aged between 30-65 years and ASA-PS classes I and II. Patients preoperative period were fasted at least 6 hrs and on arrival at OT I/V line was inserted; pulse, BP respiratory rate and SpO2 were recorded. Results: In our study fifty two (52) patients demographic data concerning the patient age, weight as well as duration of anaesthesia and type of surgery were comparable in two groups which are fairly matched. In preoperative situation in Group A mean pulse rate was 79 ±2.4, in Group B 82 ±1.5, mean anterial pressure 92.71±1.05 (Group A), 94.01±1.14 (Group B), SpO2 99±0.56 Group A, 98 ±0.26 (Group B) which showed no significant difference between the groups. In the postoperative period, incidences of shivering were 80.07% & 50% in Group-A and Group-B which are highly significant between the groups P<.001 Cardiovascular parameters SAP, DAP, MAP and SpO2 between the groups were not significant P>.05. The study showed that patients of Group-B were less shivering with good recovery. Conclusion: In concluded that the post-operative shivering are the most common complaints. The aetiology of postoperative shivering is multifactorial including anesthetic, patients and surgical factors. Antishivering prophylaxis may be justified in patients who are at great risk of developing post-operative shivering after general anaesthesia. The incidence of major side effects is not significant in ketamine group and contributes to some extent to post-operative analgesia.