Ondansetron versus Ketamine to control intra-op and post-op shivering caused by subarachnoid block: a comparative phase study

Abstract

Shivering is a common problem during anaesthesia. Ketamine has been used for preventing shivering during anaesthesia. Ondansetron (8 mg) has been recently evaluated for its peri-operative anti-shivering effect in patients undergoing spinal anaethesia. The objective of my study is to compare low dose Ondansetron with low dose Ketamine among patients undergoing spinal anesthesia in elective surgery in terms of frequency of shivering. Patients undergoing elective general surgical procedures at Department of Anesthesiology, Holy Family Hospital, Rawalpindi, were inducted in the study. The study design was a randomized control trial and conducted from Jan 2016 to June 2016. Patients were included through a consecutive non-probability sampling. After spinal anaesthesia, patients were randomly assigned to receive Ketamine 0.25 mg/kg (group A) or Ondansetron 4mg (group B) by lottery method. During surgery, shivering was recorded at 10 min interval and recorded in terms of frequency. Out of the total 256 study participants, 128 patients in each group received the study drug (Ondansetron/ Ketamine) before surgery for prevention of shivering. Overall, there were 158 male and 98 female patients. The mean age of study population was 36 ± 11 yrs(range 21–40 yrs). Shivering occurred in 11 (4.3%) patients only. There was no significant difference between the gender distributions between the two groups (p=0.16). Patients pre-treated with Ketamine significantly experienced lesser shivering episodes than Ondansetron group (2 (1.6%) vs. 9 (7%), p=0.03). The findings of our study suggest that the prophylactic administration of low dose Ketamine (0.25 mg kg-1) and Ondansetron (4mg) produces anti-shivering effect in patients undergoing spinal anaesthesia Ketamine (0.25 mg/kg) is significantly more effective than Ondansetron (4mg) during spinal anaesthesia.