Drug Design, Development and Therapy (Sep 2016)
Effect of low dose of intrathecal pethidine on the incidence and intensity of shivering during cesarean section under spinal anesthesia: a randomized, placebo-controlled, double-blind clinical trial
Abstract
Shoaleh Shami,1 Karim Nasseri,2 Mousa Shirmohammadi,3 Farzad Sarshivi,3 Negin Ghadami,3 Ebrahim Ghaderi,4 Mokhtar Pouladi,5 Arvin Barzanji1 1Department of Surgical Nursing, School of Nursing and Midwifery, Kurdistan University of Medical Sciences, Sanandaj, Iran; 2Department of Anesthesia and Intensive Care, Social Determinants of Health Research Center, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran; 3Department of Anesthesia and Intensive Care, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran; 4Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran; 5Student Research Committee, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran Introduction: Shivering is among the unpleasant and potentially harmful side effects of spinal anesthesia. The aim of this randomized double-blind clinical trial was to compare the antishivering effect of two different doses of intrathecal pethidine on the incidence and intensity of shivering and other side effects in patients who underwent cesarean section. Methods: In this study, 150 parturient females scheduled for nonemergent cesarean section were randomly allocated to three groups. Spinal anesthesia was performed with 0.5% hyperbaric bupivacaine (12.5 mg), plus 0.5 mL of 0.9% saline in the standard group (S group), and the same dose of bupivacaine with 5 mg (P5 group) or 10 mg of pethidine (P10 group). Demographic and surgical data, incidence and intensity of shivering (primary outcome), hemodynamic indices, forehead and core temperatures, maximum sensory level, Apgar scores, and adverse events were evaluated by a blinded observer. Results: There were no significant differences between the three study groups regarding the demographic and surgical data, hemodynamic indices, core temperatures, and maximum sensory level (P>0.05). The incidence and intensity of shivering were significantly less in the P5 and P10 groups (P<0.001) when compared with the S group. There were no significant differences between groups for secondary outcomes, except pruritus, which was more common in the P5 and P10 groups when compared with the S group (P=0.01). Conclusion: Low dose of intrathecal pethidine is safe, and can decrease the incidence and intensity of shivering during cesarean section, without having major side effects. Keywords: shivering, cesarean section, intrathecal pethidine, prevention, nausea, vomiting
