Wahdan Amr Samir, Loza George Eshak, Alshehri Hussain Othman, Shedid Ahmed Farag, Salama Atef Kamel, Wahdan Wessam Samir, Mohamed Mennatallah Magdi
Department of Anaesthesia, Surgical ICU and Pain Management, Cairo University Faculty of Medicine, Cairo, Egypt.
Department of Anaesthesia, Al-hada Armed Force Hospital, Taif, Saudi Arabia.
Turk J Anaesthesiol Reanim. 2023 Jun 16;51(3):199-206. doi: 10.4274/TJAR.2022.22927.
Postoperative shivering (POS) is considered one of the most common complications that is encountered by the anaesthetists worldwide. Despite using several treatment options, there has not been a clear consensus regarding this issue. This trial was conducted to investigate the efficacy and safety of paracetamol and ondansetron in preventing POS in patients undergoing liposuction procedures under combined general epidural anaesthesia.
One hundred twenty patients scheduled for liposuction were randomly allocated to one of three groups: group P (paracetamol group) which received 1 g paracetamol intravenously, group O (ondansetron group) which received 8 mg of ondansetron intravenously, and group S (saline group), which received 100 mL normal saline intravenously; all medications were given postoperatively. The primary outcome was the incidence of POS, and the secondary outcomes included shivering score, tympanic temperature, and the occurrence of side effects.
The incidence of occurrence of POS was found to be lower in groups P and O compared to group S with values of 25% and 37.50% vs. 77.50%, respectively, with a value <0.001. Additionally, the severity of POS was found to be lower in groups P and O compared to group S ( <0.001). Tympanic temperature and complications were comparable between the groups with no significant differences.
Prophylactic use of paracetamol or ondansetron at the end of the procedure was shown to be of great value in reducing the incidence and severity of POS, with no statistically significant difference between the paracetamol and ondansetron groups. Moreover, no significant drawbacks were reported as a result of using these medications.
术后寒战（POS）被认为是全球麻醉医生遇到的最常见并发症之一。尽管使用了多种治疗方法，但在这个问题上尚未达成明确共识。本试验旨在研究对乙酰氨基酚和昂丹司琼在预防接受全身联合硬膜外麻醉的抽脂手术患者发生POS方面的有效性和安全性。
120例计划进行抽脂手术的患者被随机分为三组之一：P组（对乙酰氨基酚组）静脉注射1g对乙酰氨基酚，O组（昂丹司琼组）静脉注射8mg昂丹司琼，S组（生理盐水组）静脉注射100mL生理盐水；所有药物均在术后给予。主要结局是POS的发生率，次要结局包括寒战评分、鼓膜温度和副作用的发生情况。
发现P组和O组POS的发生率低于S组，分别为25%和37.50%，而S组为77.50%，P<0.001。此外，发现P组和O组POS的严重程度低于S组（P<0.001）。各组之间的鼓膜温度和并发症具有可比性，无显著差异。
在手术结束时预防性使用对乙酰氨基酚或昂丹司琼在降低POS的发生率和严重程度方面具有重要价值，对乙酰氨基酚组和昂丹司琼组之间无统计学显著差异。此外，使用这些药物未报告明显的缺点。
