| Meperidina intratecal reduce el escalofrío intraoperatoria durante prostatectomía transuretral en pacientes ancianos |
Intrathecal meperidine reduces intraoperative shivering during transurethral prostatectomy in elderly patients.
Chun DH, Kil HK, Kim HJ, Park C, Chung KH.
Department of Anesthesiology and Pain Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
Korean J Anesthesiol. 2010 Dec;59(6):389-93. Epub 2010 Dec 31.
Abstract
BACKGROUND: Shivering is a frequent event during the perioperative period. We performed a prospective, randomized, double-blind study to determine whether intrathecal meperidine (0.2 mg/kg) decreases the incidence and intensity of shivering after spinal anesthesia for transurethral operations. METHODS: Fifty patients scheduled for elective transurethral resection operations under spinal anesthesia were randomly allocated to two groups. Spinal anesthesia consisted of 0.5% hyperbaric bupivacaine 8 mg and, mperidine (0.2 mg/kg) (meperidine group) or, normal saline (saline group). Data collection, including sensory block level (by pinprick), blood pressure, heart rate, sublingual temperature, incidence and intensity of shivering, pruritus, nausea, and vomiting was performed at 10 minute intervals. RESULTS: The incidence and intensity of shivering was significantly less in the meperidine group than saline group (P = 0.012 and P = 0.008, for incidence and intensity, respectively). However, pruritus was more common in the meperidine group compared with the saline group (16% vs. 0%, P < 0.05). CONCLUSIONS: The addition of meperidine 0.2 mg/kg to intrathecal bupivacaine lowers the incidence and severity of shivering during transurethral prostatectomy in elderly patientshttp://ekja.org/Synapse/Data/PDFData/0011KJAE/kjae-59-389.pdf
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| Estudio comparativo del efecto de clonidina y tramadol sobre el escalofrío post anestesia espinal |
A comparative study of the effect of clonidine and tramadol on post-spinal anaesthesia shivering.
Shukla U, Malhotra K, Prabhakar T.
Department of Anaesthesiology and Critical Care, UP Rural Institute of Medical Sciences & Research, Saifai, Etawah, Uttar Pradesh, India.
Indian J Anaesth. 2011 May;55(3):242-6.
Abstract
The aim of this study was to evaluate the efficacy, potency and side effects of clonidine as compared to tramadol in post-spinal anaesthesia shivering. In this prospective double-blind randomized controlled clinical trial, 80 American Society of Anaesthesiologists grade-l (ASAI) patients aged between 18 and 45 years scheduled for various surgical procedures under spinal anaesthesia, who developed shivering were selected.The patients were divided into two groups: Group C (n=40) comprised of patients who received clonidine 0.5mg/kg intravenously (IV) and group patients who received tramadol 0.5 mg/kg IV. Grade of shivering, disappearance of shivering, haemodynamics and side effects were observed at scheduled intervals. Disappearance of shivering was significantly earlier in group C (2.54±0.76) than in group T (5.01±1.02) (P=.0000001). Response rate to treatment in group C was higher (97.5%) than in group T (92.5%), but the difference was not significant. Nausea, vomiting and dizziness were found to be higher in group T (P=0.001, 0.005, 0.001, respectively), while the patients in group C were comparatively more sedated (sedation level, 2; group C, 25%). We conclude that clonidine gives better thermodynamics than tramadol, with fewer side effects
http://www.ijaweb.org/temp/IndianJAnaesth553242-7646208_020726.pdf
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| Dosis bajas de ketamina y ondansetron profilácticos para prevenir escalosfrío durante anestesia espinal |
Prophylactic low dose ketamine and ondansetron for prevention of shivering during spinal anaesthesia.
Shakya S, Chaturvedi A, Sah BP.
Department of Anaesthesiology, Manipal College of Medical Sciences, Pokhara, Nepal.
J Anaesthesiol Clin Pharmacol. 2010 Oct;26(4):465-9
Abstract
BACKGROUND:
Perioperative shivering is a common problem during anaesthesia. Apart from physical warming many drugs have also been used for prevention of shivering. Ketamine has been used for preventing shivering during anaesthesia in doses of 0.5 to 0.75mg kg(-1), but even these doses causes too much sedation and hallucination. Ondansetron (8 mg) has been recently evaluated for its perioperative antishivering effect in patients under anaethesia. Present study was conducted to evaluate the efficacy and safety of low dose Ketamine (0.25mg kg(-1)) and Ondansetron (4 mg) for prevention of shivering during spinal anaesthesia. PATIENTS #ENTITYSTARTX00026;METHODS: Total 120 patients undergoing lower abdominal surgery under spinal anaesthesia were included. 3ml of hyperbaric bupivacaine 0.5% was used for spinal anaesthesia. After intrathecal injection, the patients were randomly divided in 3 groups of 40 each who received Ketamine 0.25mg kg(-1)or Ondansetron 4mg IV or Saline. Vitals, temperature and shivering scores were recorded every 5 minutes. Side effects i.e. hypotension, nausea and vomiting, sedation and hallucinations were also recorded. RESULTS: Fall in temperature was more significant in saline and ondansetron group (gp) than in ketamine group at all time interval. Out of 40 patients, shivering was maximum & seen in 17 patients (42.50%) in saline gp, 4 patients (10%) in ondansetron gp and in only 1patient (2.5%) in ketamine gp. Odd ratio of ketamine, ondansetron and saline are 1, 4.33 and 28.33 respectively which means that shivering in saline gp was 28.83 times higher than ketamine gp and 6.65 times higher than in ondansetron .Shivering rate was 4.33 times higher in ondansetron gp than in ketamine gp. Hypotension was lowest in ketamine gp (10%) in comparison to ondansetron gp (22.5%) and saline gp. (20%). Mild sedation was seen in almost all (95%) patients in ketamine gp. CONCLUSION: Prophylactic low dose ketamine (0.25mg kg(-1)) and Ondansetron (4mg) significantly decreased shivering in patients undergoing spinal anaesthesia without significant side effectshttp://www.joacp.org/temp/JAnaesthClinPharmacol264465-5565468_152734.pdf
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