Prophylactic administration of ondansetron for prevention of shivering during spinal anesthesia

Abstract

Background and Aims: Shivering is one of the causes of discomfort in patients undergoing surgeries under spinal anesthesia. A variety of drugs and physical methods are used to control shivering. Among pharmacological interventions ondansetron, a 5-hydroxytryptamine3 antagonist has been found effective in controlling shivering. The aim of this study is to evaluate the effect of prophylactic administration of ondansetron for prevention of shivering during spinal anesthesia. Methods: A prospective, randomized, and double-blind study was conducted on 70 patients, from either gender, aged 20–60 years, of the American Society of Anesthesiologists Grade I or II, scheduled for various surgeries under spinal anesthesia. The patients were randomly divided into two groups of 35 each to receive either saline (Group S) or ondansetron 8 mg, (Group O) as slow intravenous infusion before spinal anesthesia. The primary outcome of the study was intraoperative incidence of shivering. Secondary outcomes, such as hemodynamic parameters and adverse reactions, were recorded. Results: A total of 16 patients in Group S (45.7%) and 4 (11.3%) patients in Group O experienced shivering (P = 0.014). A total of 14 patients in Group S (40%) and five patients in Group O (14.3%) had nausea (P = 0.155). A total of 11 patients in Group S (31%) and three patients in Group O (8%) had hypotension (P = 0.168). No patients in either group experienced bradycardia. Conclusion: Prophylactic administration of ondansetron significantly reduced shivering in patients undergoing spinal anesthesia without significant side effects.