THIS ARTICLE HAS BEEN RETRACTED Physostigmine for the prevention of postanaesthetic shivering following general anaesthesia – a placebo‐controlled comparison with nefopam

Abstract

SummaryPhysostigmine was studied for its efficacy in the prevention of postanaesthetic shivering compared to nefopam and placebo. We studied 89 patients undergoing abdominal and urological surgery. The study was randomised and double-blind, the patients received physostigmine 2 mg (n = 31), nefopam 10 mg (n = 30) or saline (n = 28). Haemodynamic parameters and temperature were measured at induction of anaesthesia (T0), and 5 min (T1), 15 min (T2), 30 min (T3) and 60 min (T4) after reaching the postanaesthetic care unit (PACU). Significantly less shivering occurred following administration of physostigmine and nefopam (9.7 and 3.3%) compared to placebo (53.6%). The degree of shivering was also significantly reduced following physostigmine and nefopam (p < 0.01). Extubation time, haemodynamic parameters and tympanic temperature were found to be similar in all groups. Aldrete score, duration of PACU stay and postoperative analgesic requirements did not differ between the groups. Only nefopam significantly (p < 0.01) reduced postoperative nausea and vomiting. Physostigmine is a safe alternative to nefopam, significantly reducing the incidence and severity of postanaesthetic shivering without affecting postanaesthetic recovery.

Prophylactic use of intravenous clonidine compared to tramadol in prevention of intraoperative shivering under regional anesthesia

“…[6] Human maintains the core body temperature within a narrow physiologic range, but surgery and general anesthesia can alter this delicate balance between heat loss and production by depressing the hypothalamic thermoregulatory center. [4] Prolonged impairment of thermoregulatory autonomic control coupled along with the cold environment of operating theaters and infusion of cold fluids contribute to a fall in core body temperature thus, leading to shivering.…”

Progress in shivering control

“…It has been shown to be as effective in controlling postanesthetic shivering as meperidine and clonidine [54]. It was also found to reduce the incidence and degree of shivering in postanesthetic patients comparable to nefopam [80].…”

Tremores intra e pós-operatório: prevenção e tratamento farmacológico

“…A desvantagem da meperidina é o risco de depressão respiratória, náusea e vômito. Rohm e col. 73 pesquisaram os efeitos da fisostigmina na prevenção de tremores pós-operatórios, comparando-a com o nefopam, um agente sabidamente efetivo 5 . Foram estudados 89 pacientes submetidos a procedimento cirúrgico abdominal ou urológico.…”

“…The disadvantage of meperidine is the risk of respiratory depression, nausea, and vomiting. Rohm et al 73 investigated the effects of physostigmine in the prophylaxis of postoperative tremors, and compared it with nefopam, a drug known to be effective 5 . Eighty-nine patients undergoing abdominal or urological surgeries were evaluated.…”