Effect of intrathecal meperidine and intravenous amino acid infusion in reducing intraoperative shivering during spinal anesthesia: A prospective randomized trial

Abstract

Background: This is a prospective randomized double blind study to compare the efficacy of intravenous amino acid infusion versus meperidine added to intrathecal hyperbaric bupivacaine in reducing intraoperative shivering in parturient undergoing elective cesarean section under spinal anesthesia. Methods: Sixty patients were randomly allocated into two groups. Group (A) (Amino-acid) (n = 30) who received 2 ml of 0.5% hyperbaric bupivacaine and ½ ml normal saline 0.9% (total volume 2.5 ml) intrathecal with intravenous administration of amino acids (Aminoven 5%, Fresenius Kabi), infused at rate 3 ml/kg/h with the start of spinal anesthesia and throughout the operation. Group (M) (meperidine) (n = 30) who received 2 ml of 0.5% hyperbaric bupivacaine with 10 mg meperidine in ½ ml volume (total volume 2.5 ml) intrathecal with intravenous administration of normal saline 0.9% at 3 ml/kg/h with the start of spinal anesthesia. Results: Group (A) showed significantly higher core temperature from 20 to 60 min than group (M) (p < 0.001), also the amino acid group (group A) had a significantly higher skin temperature from 10 to 60 min during surgery, and lower shivering score than group (M) (p < 0.05), during spinal anesthesia in parturients undergoing cesarean section. Conclusion: Amino acids infusion decreased the incidence of shivering, increased peripheral and core temperature than intrathecal meperidine, which seems a safer alternative, more effective with lesser side effects than intrathecal meperidine in parturients undergoing cesarean section under spinal anesthesia.

Keywords

• Shivering
• Meperidine
• Amino acids
• Cesarean section
• Bupivacaine