Efficacy of granisetron on prevention of shivering, nausea and vomiting during cesarean delivery under spinal anesthesia: A randomized double-blinded clinical trial

Abstract

Background: Hypothermia, shivering, nausea and vomiting are frequent perioperative events in patients undergoing cesarean delivery under spinal anesthesia. Apart from physical warming for shivering many drugs have also been used for prevention of these events. Objectives: We conducted a randomized double-blinded clinical trial to evaluate the effect of a single drug, granisetron on prevention of shivering, nausea and vomiting during cesarean section performed under spinal anesthesia. Materials and Methods: One hundred American Society of Anesthesiologists I-II patients undergoing elective cesarean section under spinal anesthesia were randomly allocated into two groups, control saline (n = 50) or granisetron groups (n = 50). Warmed (37°C) lactated ringer's solution was infused over 15 min before anesthesia. Spinal block was performed with the same technique in both groups. In the saline group 3 ml of 0.9% saline and in granisetron 3 mg (3 ml) granisetron was injected intravenously after intrathecal injection at identical times. Shivering, maximum and minimum level of spinal block, core body temperature, nausea and vomiting and need to treat shivering with intravenous pethidine and neonates APGAR scores were all recorded. Results: Demographic data, median of sensory block level and mean core body temperature were not statistically different in groups. Eight percent (4/50) of patients in granisetron and 54% (27/50) of patients in the saline group had shivering during the perioperative period that was treated with pethidine (P = 0.001). Ten patients (20%) in granisetron and 30 patients (60%) in saline group had nausea (P = 0.002). No patients in both groups needed rescue medication. 1 st and 5 th minutes APGAR scores of neonates were not statistically different in the groups. Ten patients (20%) in granisetron and 30 patients (60%) in saline group had nausea (P = 0.002). Conclusions: Granisetron is an effective way to prevent shivering, nausea and vomiting during cesarean delivery under spinal anesthesia with no effect on APGAR score.