J Res Pharm Pract. 2014 Jul;3(3):94-9. doi: 10.4103/2279-042X.141105.

Prophylactic effects of intrathecal Meperidine and intravenous Ondansetron on shivering in patients undergoing lower extremity orthopedic surgery under spinal anesthesia.

Journal of research in pharmacy practice

Mohammadreza Safavi, Azim Honarmand, Maryam Negahban, Mohammadali Attari

PMID: 25328899 PMCID: PMC4199198 DOI: 10.4103/2279-042X.141105

Abstract

OBJECTIVE: Intraoperative hypothermia is a common problem with anesthesia. Spinal anesthesia, the same as general anesthesia, affects the process of temperature regulation. The aim of this study was to compare the prophylactic effect of intravenous (IV) ondansetron with intrathecal (IT) meperidine on prevention of shivering during spinal anesthesia in patients underwent orthopedic surgery of the lower limb.

METHODS: In this study, 120 patients with American Society of Anesthesiologists physical status I to II, between the ages 16 and 65 were randomized into three groups. Group O and Group M were given IV ondansetron 8 mg and IT meperidine 0.2 mg/kg, before spinal anesthesia, respectively. Group C received IV saline 0.9%. The core and ambient temperatures, the incidence and intensity of shivering, blood pressure, heart rate, and maximum level of sensory block were recorded.

FINDINGS: Shivering was observed in 15%, 2.5%, and 37.5% of patients in Groups O, M, and C, respectively. There was a significant difference between Group O and M compared to Group C (P = 0.023 for Group O vs. Group C, P < 0.001 for Group M vs. Group C, P = 0.049 for Group M vs. Group O). Shivering incidence and intensity in Group M was significantly lower than Group O (P = 0.049 and P = 0.047, respectively). Twenty-two patients required additional IV meperidine among which 15 patients were from Group C (37.5%), six patients from Group O (15%) and one patient from Group M (2.5%).

CONCLUSION: We concluded that IT meperidine and IV ondansetron comparably can decrease intensity and incidence of shivering compared to control group as well as decreasing the requirement to additional doses of meperidine for shivering the control without any hemodynamic side effect.

Keywords: Hypothermia; Meperidine; Ondansetron; orthopedic surgery; shivering; spinal anesthesia

References

1. Drugs. 2001;61(15):2193-205 - PubMed
2. Can J Anaesth. 1992 Sep;39(7):655-60 - PubMed
3. Anesthesiology. 1997 May;86(5):1046-54 - PubMed
4. N Engl J Med. 1996 May 9;334(19):1209-15 - PubMed
5. Anesthesiology. 1995 Mar;82(3):662-73 - PubMed
6. Anesth Analg. 2002 Jan;94(1):213-4, table of contents - PubMed
7. Ma Zui Xue Za Zhi. 1993 Mar;31(1):19-24 - PubMed
8. Anesth Analg. 2004 Jan;98(1):230-234 - PubMed
9. Anesthesiology. 2002 Feb;96(2):467-84 - PubMed
10. Anesth Analg. 1999 Apr;88(4):827-30 - PubMed
11. Can J Anaesth. 1994 Aug;41(8):725-7 - PubMed
12. Can J Anaesth. 1990 Jul;37(5):567-70 - PubMed
13. Anesthesiology. 1996 Jun;84(6):1327-31 - PubMed
14. Reg Anesth Pain Med. 2006 Jan-Feb;31(1):40-5 - PubMed
15. Anesth Analg. 1987 Mar;66(3):235-40 - PubMed
16. Anesthesiology. 1993 Dec;79(6):1193-201 - PubMed
17. Brain Res. 1977 Oct 7;134(2):297-315 - PubMed
18. Anaesthesia. 1994 Mar;49(3):205-7 - PubMed
19. Urol J. 2007 Fall;4(4):212-6 - PubMed
20. Anesthesiology. 1994 Aug;81(2):282-8 - PubMed
21. Br J Clin Pharmacol. 1996 Sep;42(3):307-11 - PubMed
22. Anaesthesia. 1995 Mar;50(3):214-7 - PubMed
23. Anesthesiology. 1993 Mar;78(3):468-76 - PubMed
24. Anesth Analg. 2000 Jun;90(6):1423-7 - PubMed
25. Anesth Analg. 1999 Mar;88(3):686-9 - PubMed
26. Anesth Analg. 2002 Feb;94(2):453-60, table of contents - PubMed
27. Acta Anaesthesiol Scand. 1984 Apr;28(2):138-43 - PubMed
28. Anesthesiology. 1995 Nov;83(5):961-7 - PubMed

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