Efficacy of Prophylactic Ketamine, Ondansetron, and Pethidine in Preventing Perioperative Shivering in Patients Undergoing Elective Knee Replacement Surgery Under Spinal Anaesthesia

R, Ramanathan; Sethi, Rishabh; Singh, Shalendra; Varshney, Mudit; Das, Debasish; Nandagopalou, Dheebakraj; Dwivedi, Deepak

doi:10.5152/tjar.2021.20444

Cited by 3 publications

(1 citation statement)

References 26 publications

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“…In contrast to ondansetron, palonosetron, a newer 5-HT3 antagonist, has not been found to influence perioperative hypothermia or postanesthetic shivering significantly, indicating differences in efficacy compared to ondansetron in this context. Additionally, research highlights the potential of low-dose ketamine and ondansetron in preventing shivering during spinal anesthesia, although comparative studies evaluating their use are limited [31] . The relative preservation of temperature observed in ketamine groups may be attributed to the vasoconstrictive action of ketamine, while the difference in ondansetron's effectiveness between studies could be attributed to variations in dosage [32,33] .…”

Section: Fig (1) Schematic Representation Of Moa Of Tramadolmentioning

confidence: 99%

New Approach in Prevention of Shivering with Spinal Anesthesia

Afifi,

Abouseeda,

Mohamed

2023

Benha Journal of Applied Sciences

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Background: Shivering during spinal anesthesia is a multifactorial challenge triggered by factors such as cold environments and vasodilation, leading to discomfort, increased oxygen consumption, and potential surgical complications. Effective prevention and management strategies are essential to ensure patient well-being. This review article explores a range of methods, including nonpharmacological and pharmacological approaches, for shivering prevention during spinal anesthesia, considering patient-specific factors and potential side effects, while also highlighting recent advancements in this field and their clinical implications. Objective: The aim of this review article is to provide a comprehensive overview of recent advancements and approaches in the prevention of shivering during spinal anesthesia. It explores the mechanisms underlying shivering, discusses a wide range of pharmacological interventions, highlights non-pharmacological strategies, and offers insights into clinical considerations. Conclusions: Shivering during spinal anesthesia remains a significant concern, but recent developments in both non-pharmacological and pharmacological methods offer promising avenues for prevention and management.

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Section: Fig (1) Schematic Representation Of Moa Of Tramadolmentioning

confidence: 99%

New Approach in Prevention of Shivering with Spinal Anesthesia

Afifi,

Abouseeda,

Mohamed

2023

Benha Journal of Applied Sciences

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The relationship between operation duration and shivering in post-spinal anaesthesia patients

Renaningtyastutik

Lumadi²,

Handian³

2022

J Pal Nurs Stud

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Background: Giving spinal anaesthesia is an effort to relieve pain to create optimal conditions for surgery operation consciously. A shivering event frequently follows the phenomenon of the long duration of the operation. Purpose: The study aimed to determine the relationship between operation duration and shivering in post spinal anaesthesia patients. Methods: The study design is a quantitative study and uses a cross-sectional approach. Sampling used a systematic sampling technique on the population of patients undergoing surgery under spinal anaesthesia. The instrument used Croessley and Mahajan’s observation sheet. This study uses Spearman rank rho as the statistical test with a significant value of p=0.05. Results: The study showed almost respondents, as many as 86.15 respondents (56 patients) experienced shivering. Based on the Spearman statistical test, the p-value is 0.046. Conclusions: It can be concluded that there was a relationship between operation duration and incidence of shivering. Therefore, to reduce the occurrence of shivering, it is necessary to take measures such as giving warm blankets, warm fluids, and tools to maintain body temperature (force air warming).

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A Scoping Review: Ketamine for the Prevention of Perioperative Shivering in Patients Undergoing Spinal Anesthesia

Goich,

Pastore,

Koutsenko

et al. 2024

Cureus

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Shivering is a frequently encountered perioperative complication in patients undergoing spinal anesthesia. Numerous different pharmacological agents have been employed to mitigate this issue. This scoping review aims to evaluate the efficacy of ketamine in mitigating the incidence of shivering. This review process utilized PubMed, JAMA, and Cochrane as primary databases. Searches were performed using combinations of key terms: "Ketamine," "Shivering," "Spinal Anesthesia," and "Hypothermia." Reviews of reference lists for additional pertinent data were performed. When ketamine was compared against a saline control, three out of five studies found ketamine to be more effective (p < 0.05, p < 0.001, p < 0.001) in the prevention of shivering. When compared with tramadol, two studies found ketamine to be more effective (p < 0.001, p < 0.001), one found no difference (p = 0.261), and one found tramadol to be more effective (p < 0.001). Two studies found dexmedetomidine more effective (p < 0.022, p < 0.027) than ketamine and tramadol. When comparing ketamine, ondansetron, and meperidine, all three were effective (p < 0.001) versus saline, with no significant difference between the three. Meperidine demonstrated more efficacy (p < 0.05) in reducing the intensity of shivering than ketamine. Ketamine's effects on hemodynamics were shown to be equivocal or more favorable across several studies. While there is mixed evidence on whether it is better than other treatments, ketamine may have advantages from a hemodynamic standpoint. Dosages of 0.2-0.5 mg/kg with or without a subsequent infusion of 0.1 mg/kg per hour may aid in the prevention of perioperative shivering. Overall, ketamine is a safe and effective drug for the prevention of perioperative shivering. However, other drugs may be equally or more effective; therefore, patient population, hemodynamic status, patient preferences, and provider familiarity with different agents should be considered.

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Efficacy of Prophylactic Ketamine, Ondansetron, and Pethidine in Preventing Perioperative Shivering in Patients Undergoing Elective Knee Replacement Surgery Under Spinal Anaesthesia

Cited by 3 publications

References 26 publications

New Approach in Prevention of Shivering with Spinal Anesthesia

New Approach in Prevention of Shivering with Spinal Anesthesia

The relationship between operation duration and shivering in post-spinal anaesthesia patients

A Scoping Review: Ketamine for the Prevention of Perioperative Shivering in Patients Undergoing Spinal Anesthesia

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