Abstract
Purpose: Post-anesthesia shivering is one of the most common problems after surgery and may lead to multiple complications such as hypoxemia, lactate acidosis and catecholamine release. The purpose of this study was to compare the effects of intravenous meperidine and ondansetron on postoperative shivering in patients having an elective cesarean section under spinal anesthesia. Design: Cross-sectional study Methods: In this cross-sectional study, 105 patients with the age of 18-45 years and ASA class I-II undergoing elective cesarean section were randomly assigned into three groups. Group O was administered 8mg ondansetron, group M patients were given 0.4mg/kg meperidine and group P was placebo that was administered with 2cc of saline intravenously after the delivery. The incidence and intensity of shivering and postoperative nausea was monitored and recorded by the trained nurse. The data obtained was analyzed using SPSS v18. Results: All three groups (n=35) had no significant difference in terms of age, weight and time of spinal anesthesia. Postoperative shivering was reported in 4 patients (11.4%) in group A and 3 patients (8.6%) in group B and in 14 patients (40%) in group C. The incidence of postoperative shivering was significantly less in groups A and B as compared to the placebo, p=0.03. The intensity of shivering was greater in group C as compared to groups A and B, p=0.01. The incidence and intensity of postoperative nausea was significantly less in group A, p=0.03, p<0.001, respectively, while no difference was reported in groups B and C, p<0.05. Conclusion: 8mg ondansetron and 0.4 mg/kg of meperidine are equally effective in managing postoperative shivering; however, ondansetron has an additional effect of reducing the incidence of postoperative nausea among patients undergoing caesarean section with spinal anesthesia.
Highlights
Spinal anesthesia is commonly used anesthetic technique for a number of surgical procedures including cesarean section due to the rapidity in achieving numbness, clinical efficacy and reduced postoperative complications such as hemodynamic alterations and adverse effects on mental status [1]
Ondansetron is a 5-HT3 antagonist that is widely known for its anti-emetic effects and to treat postoperative nausea and vomit
The aim of this study is to evaluate the effects of meperidine and ondansetron on postoperative shivering among patients undergoing elective cesarean section with spinal anesthesia
Summary
Spinal anesthesia is commonly used anesthetic technique for a number of surgical procedures including cesarean section due to the rapidity in achieving numbness, clinical efficacy and reduced postoperative complications such as hemodynamic alterations and adverse effects on mental status [1]. Postoperative shivering is one of the common complications. 0.4mg/kg of meperidine is an optimal dose in the management of postoperative shivering [7, 8]. The 5HT3 system is known to play a significant role in postoperative shivering [11]. 5-HT3 receptor antagonists such as granisetron have been reported to reduce the incidence of shivering [1]. Ondansetron is a 5-HT3 antagonist that is widely known for its anti-emetic effects and to treat postoperative nausea and vomit. Some studies have suggested its efficacy against postoperative shivering [12]
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