Volume 31, Issue 6 (September 2020)
Studies in Medical Sciences 2020, 31(6): 423-432 |
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Golmohammadi M, Karami N, Tahmasebi R. INCIDENCE OF SHIVERING DURING CESAREAN SECTION IN PATIENTS UNDER SPINAL ANESTHESIA WITH OR WITHOUT FENTANYL. Studies in Medical Sciences 2020; 31 (6) :423-432
URL: http://umj.umsu.ac.ir/article-1-5078-en.html
URL: http://umj.umsu.ac.ir/article-1-5078-en.html
Assistant Professor of Anesthesiology, Anesthesiology Department, Clinical Research Development Unit of Imam Khomeini Hospital, Urmia University of Medical Sciences, Urmia, Iran: (Corresponding Author) , nazlikarami@yahoo.com
Abstract: (5115 Views)
Background & Aims: Postoperative shivering is one of the common complications of surgery in the recovery room, with an incidence rate of about 50-60% in various reports. Postoperative chills usually result in unwanted hypothermia during operation.
Materials & Methods: In this study, patients were divided randomly (after selecting one of 32 card containing coatings) into intervention group (n=45) and the placebo group (n=45). This was done by anesthesiologist who had no intervention in the study, and anesthesiologist and patients did not receive information about the drugs received and the examination of chills and severity of chills was performed by a person who was not aware of the way of study.
Results: There was a significant difference in the frequency of shivering between the intervention group (fentanyl) and the placebo group (without fentanyl) (p <0.001). There was no significant difference regarding severity of shivering between the intervention group and the placebo group (p = 450.0). There was no significant difference in vomiting between the intervention group and the placebo group (p=.184). There was a significant difference between the intervention group and the placebo group (p = 0.003) with regard to nausea. Because vomiting was only recovered in the placebo group (without fentanyl), there were 2 patients and in the intervention group (fentanyl), vomiting was not recovered at all. Therefore, no significant difference was observed regarding frequency of vomiting between the intervention group and the placebo group. There was no significant difference in the vomiting time between the intervention group and the placebo group (p = 0.69). There was a significant difference between the intervention group and the placebo group regarding pruritus (p <0.001).
Conclusion: Most of the patients who received fentanyl had less shivering during surgery and recovery than those who did not receive fentanyl, and most of the patients who received fentanyl had less nausea during operation and recovery than those who did not receive fentanyl and those who received fentanyl have had more pruritus during operation and recovery than those who did not receive fentanyl. Also, taking fentanyl is effective in itching during surgery and recovery.
Materials & Methods: In this study, patients were divided randomly (after selecting one of 32 card containing coatings) into intervention group (n=45) and the placebo group (n=45). This was done by anesthesiologist who had no intervention in the study, and anesthesiologist and patients did not receive information about the drugs received and the examination of chills and severity of chills was performed by a person who was not aware of the way of study.
Results: There was a significant difference in the frequency of shivering between the intervention group (fentanyl) and the placebo group (without fentanyl) (p <0.001). There was no significant difference regarding severity of shivering between the intervention group and the placebo group (p = 450.0). There was no significant difference in vomiting between the intervention group and the placebo group (p=.184). There was a significant difference between the intervention group and the placebo group (p = 0.003) with regard to nausea. Because vomiting was only recovered in the placebo group (without fentanyl), there were 2 patients and in the intervention group (fentanyl), vomiting was not recovered at all. Therefore, no significant difference was observed regarding frequency of vomiting between the intervention group and the placebo group. There was no significant difference in the vomiting time between the intervention group and the placebo group (p = 0.69). There was a significant difference between the intervention group and the placebo group regarding pruritus (p <0.001).
Conclusion: Most of the patients who received fentanyl had less shivering during surgery and recovery than those who did not receive fentanyl, and most of the patients who received fentanyl had less nausea during operation and recovery than those who did not receive fentanyl and those who received fentanyl have had more pruritus during operation and recovery than those who did not receive fentanyl. Also, taking fentanyl is effective in itching during surgery and recovery.
Type of Study: Clinical trials |
Subject:
Anesthesia
References
1. Sellden E, Lindahl. Amino acid-induced thermogenesis reduces hypothermia during anesthesia and shortness hospital stay. Anesth Analg 1999;89:1551-6.
https://doi.org/10.1213/00000539-199912000-00045 [DOI:10.1097/00000539-199912000-00045] [PMID]
2. Chan AM, Ng KF, Tong EW, Jan GS. Control of shivering under regional Anesthesia in obstetric Patient with tramadol. Can J Anesth 1999;46:253-8. [DOI:10.1007/BF03012605] [PMID]
3. Berti M, Fanelli G, Casati A, Aldegheri G, Lugani D, Torri G. Hypothermia prevention and treatment. Anesthesia 1998;53:46-7. [DOI:10.1111/j.1365-2044.1998.tb15151.x] [PMID]
4. De Whitte J, Sessler DI. Perioperative shivering: Physiology and pharmacology. Anesthesiolg 2002; 96:467-84. [DOI:10.1097/00000542-200202000-00036] [PMID]
5. Sessler DI, Ponte J. Shivering during epidural anesthesia. Anesthesiolgy1990;72(5):816-21. [DOI:10.1097/00000542-199005000-00008] [PMID]
6. Park B, Lee T, Berger K, Park SM, Choi KE, Goodsell TM, et al. Efficacy of nonpharmacological ant shivering interventions: A systemic analysis. Survey of Anesthesiology2015;60(3):121-. [DOI:10.1097/01.sa.0000482093.34310.61]
7. Bhatnagar S, Saxena A, Kannan TR, Punj J, Panigrahi M, Mishra S. Tramadol for postoperative shivering: a double-blind comparison with pethidine. Anaesth Intensive Care 2001;29(2):149-54. [DOI:10.1177/0310057X0102900209] [PMID]
8. Katyal S, T Tewari A. Shivering. Anesthetic consideration. J Anesth Clin Oharmacol 2002; 18: 363-76.
9. Sessler DI. Temperature monitoring In: Miller RD 5th ed. textbook of anesthesia. Churchill Livingstone Inc, New York; 1994. P.1367-89. [PMID] [PMCID]
10. Mathews S, Al Mulla A, Varghese PK, Radim K, Mumtaz S. Postanaesthetic shivering--a new look at tramadol. Anaesthesia 2002; 57: 394-8. [DOI:10.1046/j.1365-2044.2002.2457_3.x] [PMID]
11. Wrench IJ1, Cavill G, Ward JE, Crossley AW. Comparison between alfentanil, pethidine and placebo in the treatment of post-anaesthetic shivering. Br J Anaesth 1997; 79: 541-2. [DOI:10.1093/bja/79.4.541] [PMID]
12. Ikeda T, Sessler DI, Tayefeh F, Negishi C, Turakhia M, Marder D, et al. Meperidine and alfentanil do not reduce the gain or maximum intensity of shivering. Anesthesiology 1998; 88: 858-65. [DOI:10.1097/00000542-199804000-00003] [PMID]
13. Tsai YC, Chu KS. A comparison of tramadol, amitriptyline, and meperidine for postepidural anesthetic shivering in parturients. Anesth Analg 2001;93:1288-92. [DOI:10.1097/00000539-200111000-00052] [PMID]
14. Kranke P, Eberhart LH, Roewer N, Tramer MR. Pharmacological treatment of postoperative shivering: a quantitative systematic review of randomized controlled trials. Anesth Analg 2002; 94:453-60.
https://doi.org/10.1213/00000539-200202000-00043 [DOI:10.1097/00000539-200202000-00043] [PMID]
15. Piper SN, Fent MT, Röhm KD, Maleck WH, Suttner SW, Boldt J. Urapidil does not prevent postanesthetic shivering: a dose-ranging study. Can J Anaesth 2001;48:742-7. [DOI:10.1007/BF03016688] [PMID]
16. Chow TC, Cho PH. The influence of small dose intrathecal fentanyl on shivering during transurethral resection of prostate under spinal anesthesia. Acta Anaesth Singapore 1994;32(3):165-70. [Google Scholar]
17. Techanivate A, Urusopone P, Kiatgungwangliam P, Kosawiboonpol R. Intratechal fentanyl in spinal anesthesia for appendectomy. J Med Assoc Thai 2004;87(5):525-30. [PMID]
18. Techanivate A, Rodanant O, Tachawattanwisel W, Somsiri T. Intratechal fentanyl for prevention of shivering in cesarean section. J Med Assoc Thai 2005;88 (9):1214-21. [PMID]
19. Sadegh A, Tazeh-Kand NF, Eslami B. Intrathecal fentanyl for prevention of shivering in spinal anesthesia in cesarean section. Med J Islam Repub Iran 2012; 26:85-9. [PMID] [PMCID]
20. Onk D, Akrsu Ayazoglu T, Kuyrukluyildiz U, Aksut M, Bedri Z, Kupeli I, et al. Effect of fentanyl and Morphin on Shivering During Spinal Anesthesia in Patient Undergoing Endovenous Ablation of varicose veins. Med Sci Monit 2016; 22: 469-73. [DOI:10.12659/MSM.897256] [PMID] [PMCID]
21. Denis Roy J,Girard M, Drolet P. Intrathechal Meperidine Decreases Shivering During Cesarean Delivery Under Spinal Anesthesia. Anesth Analg 2004; 98: 230-4. [DOI:10.1213/01.ANE.0000093251.42341.74] [PMID]
22. Gani H, Naco M, Beqiri V, Janko A, Hoxha B, Domi R. Comparision of meperidine and fentanyl for prevention of shivering during spinal anesthesia. International Research Journal Of Medicine and Biomedical Sciences Vol.1-(2),pp.19-22.April2016. [URL]
23. Locks GD. Incidence of shivering after Cesarean Section under Spinal Anesthesia with or without Intrathecal Sufentanil: A randomized study. Rev Bras Anestesiol 2012;62(5):676-84. [DOI:10.1016/S0034-7094(12)70166-6] [PMID]
24. .Hong J-Y, Lee IH. Comparison of effects of intratechal morphine and pethidine on shivering after cesarean delivery under combined-spinal epidural anesthesia. Anesthesia 2005; 60:1168-72 . [DOI:10.1111/j.1365-2044.2005.04158.x] [PMID]
25. Prasad RB, Joel CJ, Zachariah VK. Effectiveness of Addition OF Intrathechal Tramadol with Hyperbaric Bupivacaine in Prevention of Shivering in Parturient Undergoing Cesarean Section Under Spinal Anesthesia: A Randomized Placebo - controlled Study. Karnataka Anesthesia Journal 2015; 1(3):123-7. [DOI:10.4103/2394-6954.173536]
26. Chaturvedi S, Domkondwar G. Control of shivering under regional anesthesia using tramadol. Asian archives of Anesthesiology and resuscitation 2002; 57: 706-7.
27. Chu CC, Shu SS, Lin SM, Chu NW. The effect of intrathecal bupivacaine with combined fentanyl in caesarean section. Acta Anaesth Singapore 1995;33(3):149-54 [Google Scholar]
28. Rueben SS, Dunn SM, Dupart KM, O'Sullivan P. An intrathecal fentanyl dose-response study in lower extremity revascularization procedures. Anesthesiology 1994;81(6):1371-5 [DOI:10.1097/00000542-199412000-00011] [PMID]
29. De Figueiredo Locks G. Incidence of shivering after cesarean section under spinal anesthesia with or without intrathecal sufentanil: a randomized study. Rev Bras Anestesiol 2012; 62(5):676-84. [DOI:10.1016/S0034-7094(12)70166-6] [PMID]
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