Cross-sectional Study on Effects of Ondansetron and Meperidine in the Prevention of Postoperative Shivering after Spinal Anesthesia

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.

The duration of spinal anesthesia in elective cesarean section in Trendelenburg and reverse Trendelenburg positions: a randomized clinical trial

“…In related studies in this field, different results were obtained compared to our study, such as in the study conducted by Kumar and colleagues, where significantly higher sensory levels above the T8 vertebra were found in the group using the inverted Trendelenburg position compared to the supine position. This indicates higher and lower sensory levels in the inverted Trendelenburg position than in the supine position 21 , 22 .…”