Safavi Mohammadreza, Honarmand Azim, Negahban Maryam, Attari Mohammadali
Department of Anesthesia and Intensive Care Medicine, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
J Res Pharm Pract. 2014 Jul;3(3):94-9. doi: 10.4103/2279-042X.141105.
Intraoperative hypothermia is a common problem with anesthesia. Spinal anesthesia, the same as general anesthesia, affects the process of temperature regulation. The aim of this study was to compare the prophylactic effect of intravenous (IV) ondansetron with intrathecal (IT) meperidine on prevention of shivering during spinal anesthesia in patients underwent orthopedic surgery of the lower limb.
In this study, 120 patients with American Society of Anesthesiologists physical status I to II, between the ages 16 and 65 were randomized into three groups. Group O and Group M were given IV ondansetron 8 mg and IT meperidine 0.2 mg/kg, before spinal anesthesia, respectively. Group C received IV saline 0.9%. The core and ambient temperatures, the incidence and intensity of shivering, blood pressure, heart rate, and maximum level of sensory block were recorded.
Shivering was observed in 15%, 2.5%, and 37.5% of patients in Groups O, M, and C, respectively. There was a significant difference between Group O and M compared to Group C (P = 0.023 for Group O vs. Group C, P < 0.001 for Group M vs. Group C, P = 0.049 for Group M vs. Group O). Shivering incidence and intensity in Group M was significantly lower than Group O (P = 0.049 and P = 0.047, respectively). Twenty-two patients required additional IV meperidine among which 15 patients were from Group C (37.5%), six patients from Group O (15%) and one patient from Group M (2.5%).
We concluded that IT meperidine and IV ondansetron comparably can decrease intensity and incidence of shivering compared to control group as well as decreasing the requirement to additional doses of meperidine for shivering the control without any hemodynamic side effect.
术中低体温是麻醉常见问题。脊髓麻醉与全身麻醉一样，会影响体温调节过程。本研究旨在比较静脉注射昂丹司琼与鞘内注射哌替啶对接受下肢骨科手术患者脊髓麻醉期间寒战的预防效果。
本研究中，120例美国麻醉医师协会身体状况分级为I至II级、年龄在16至65岁之间的患者被随机分为三组。O组和M组在脊髓麻醉前分别静脉注射8 mg昂丹司琼和鞘内注射0.2 mg/kg哌替啶。C组接受0.9%生理盐水静脉注射。记录核心温度和环境温度、寒战的发生率和强度、血压、心率以及感觉阻滞的最高平面。
O组、M组和C组患者的寒战发生率分别为15%、2.5%和37.5%。与C组相比，O组和M组之间存在显著差异（O组与C组比较，P = 0.023；M组与C组比较，P < 0.001；M组与O组比较，P = 0.049）。M组的寒战发生率和强度显著低于O组（分别为P = 0.049和P = 0.047）。22例患者需要额外静脉注射哌替啶，其中15例来自C组（37.5%），6例来自O组（15%），1例来自M组（2.5%）。
我们得出结论，与对照组相比，鞘内注射哌替啶和静脉注射昂丹司琼均可同等程度降低寒战强度和发生率，且可减少因寒战控制而额外使用哌替啶的需求，且无任何血流动力学副作用。
