Department of Anesthesiology, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.
Determinants of Health Research Center, Department of Community Medicine, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.
Int Tinnitus J. 2024 Mar 21;27(2):160-166. doi: 10.5935/0946-5448.20230025.
Recently, use of HT35 receptor antagonists to prevent postoperative shivering has attracted a great deal of attention. This study was conducted with the aim of investigating the effectiveness of granisetron as an HT35 antagonist when compared with ondansetron and meperidine in preventing postoperative shivering.
In this triple blind random clinical trial study, 90 patients 18-50 years of age with ASA Class I and II undergoing general anesthesia were randomly assigned into one of the three drug groups: O (4-mg ondansetron), G (40 μg/kg of granisetron), and P (25 mg meperidine), immediately before induction of anesthesia. After anesthesia induction, at the end of the surgery, after the entrance and after leaving the recovery state, central temperature, peripheral temperature, heart rate, systolic blood pressure, diastolic blood pressure, and shivering were measured and documented. Two-tailed P < 0.05 was considered significant.
In the meperidine, ondansetron, and granisetron groups, 4 (13.3%), 3 (10%), and 10 (33.3%) of patients experienced shivering during recovery, where the difference between the ondansetron and granisetron groups was significant (p-value=0.02). The variations in the mean arterial pressure during the investigation stages only in the ondansetron group were not significant (p>0.05). At the beginning of recovery, the reduction of peripheral temperature significantly was lower in the ondansetron group (p<0.05), while reduction of the central temperature was significantly (p<0.05) higher in the granisetron group. By the end of the recovery, the variations in the peripheral temperature across the three groups were consistent with the changes at the beginning of recovery, but variations of the central temperature across the three groups was not significantly diverse.
Granisetron was not found to be much effective in preventing postoperative shivering. Ondansetron and meperidine were equally effective in preventing postoperative shivering. Ondansetron also causes less hemodynamic changes compared to other drugs, while granisetron is more effective in terms of preventing nausea and vomiting.
最近，使用 HT35 受体拮抗剂预防术后寒战引起了广泛关注。本研究旨在比较曲司氯铵、昂丹司琼和哌替啶作为 HT35 拮抗剂预防术后寒战的效果。
在这项三盲随机临床试验中，将 90 名年龄在 18-50 岁、ASA 分级 I 和 II 级的全麻患者随机分为三组：O 组（4mg 昂丹司琼）、G 组（40μg/kg 曲司氯铵）和 P 组（25mg 哌替啶），在麻醉诱导前立即给予药物。麻醉诱导后、手术结束时、进入恢复室后和离开恢复室后，测量并记录中心体温、外周体温、心率、收缩压、舒张压和寒战情况。双侧 P<0.05 为差异有统计学意义。
在哌替啶、昂丹司琼和曲司氯铵组中，有 4（13.3%）、3（10%）和 10（33.3%）名患者在恢复期间出现寒战，昂丹司琼组和曲司氯铵组之间的差异有统计学意义（p 值=0.02）。在研究阶段，只有昂丹司琼组的平均动脉压变化无统计学意义（p>0.05）。在恢复开始时，昂丹司琼组外周体温的下降显著较低（p<0.05），而曲司氯铵组中心体温的升高显著较高（p<0.05）。在恢复结束时，三组的外周体温变化与恢复开始时一致，但三组的中心体温变化无显著差异。
曲司氯铵预防术后寒战的效果并不显著。昂丹司琼和哌替啶预防术后寒战的效果相当。与其他药物相比，昂丹司琼引起的血液动力学变化较小，而曲司氯铵在预防恶心和呕吐方面更有效。
