Intravenous Ondansetron Efficacy in Preventing Post Spinal Shivering during Lower Segment Caesarean Section
DOI:
https://doi.org/10.51253/pafmj.v73i6.6688Keywords:
Intravenous ondansetron, Spinal anaesthesia, Post-operative shiveringAbstract
Objective: To determine IV Ondansetron efficacy in preventing post-spinal shivering during LSCS.
Study Design: Quasi-experimental study.
Place and Duration of Study: Department of Anaesthesiology, Combined Military Hospital, Rawalpindi Pakistan, from Sep
2018 to Mar 2019.
Methodology: A total of 60 women undergoing LSCS under spinal anaesthesia were included. Group-A was given 8 mg/4 ml Ondansetron, while Group-B was given 4 ml Normal Saline 0.9% IV immediately before induction of spinal anaesthesia. Body temperature, level of sensory block, and shivering scores during the peri-operative period were recorded. After surgery, patients were shifted to Post Anaesthesia Care Unit (PACU). Shivering was graded using Crossley and Mahajan 5-item scale. Injection Tramadol 1mg/kg intravenously was used as a rescue anti-shivering drug.
Results: The majority of the patients 33(55.0%) were between 18-25 years of age. Efficacy of Intravenous Ondansetron in
preventing post-operative shivering during spinal anaesthesia in patients undergoing caesarean section was seen in 26
86(67%) patients (Group-A) as compared to 17(56.67%) patients in the Control Group (Group-B) (p-value=0.010).
Conclusion: The study concluded that there was less post-operative shivering with intravenous Ondansetron during spinal
anaesthesia in patients undergoing caesarean section as compared to the Control Group.
Downloads
References
Duggappa DR, Lokesh M, Dixit A, Paul R, Raghavendra Rao RS,Prabha P, et al. Perfusion index as a predictor ofhypotensionfollowing spinal anaesthesia in lower segment caesarean section.Indian J Anaesth 2017; 61(8): 649654.https://doi.org/10.4103/ija.ija_429_16.
Singh R, Gupta D, Jain A. The effect of addition of intrathecalclonidine to hyperbaric bupivacaine on postoperative painafterlower segment caesarean section. Saudi J Anaesth 2013; 7(3): 283–290. https://doi.org/10.4103%2F1658-354X.115360.
Ferré F, Martin C, Bosch L, Kurrek M, Lairez O, Minville V , et al.Control of spinal anesthesia-induced hypotension in adults.Local Reg Anesth 2020; 13:39.https://doi.org/10.2147/lra.s240753.
Chatterjee A, Gudiwada B, Mahanty PR, Kumar H, Nag DS,Ganguly PK, et al. Effectiveness of Granisetron in prevention ofhypotension following spinal anaesthesia in patients undergoingelective caesarean section. Cureus 2020; 12(12): e12113.https://doi.org10.7759/cureus.12113.
Rai S, Verma S, Pandey HP, Yadav P, Patel A. Role ofbutorphanol and ondansetron premedication in reducingpostoperativeshivering after general and spinal anesthesia.Anesth Essays Res 2016; 10(2): 319-323.https://doi.org10.4103/0259-1162.172724.
Bozgeyik S, Mizrak A, Kiliç E, Yendi F, Ugur BK. The effects ofpreemptive tramadol and dexmedetomidine on shivering duringarthroscopy. Saudi J Anaesth2014; 8(2): 238-243.https://doi.org10.4103/1658-354X.130729.
Venkatraman R, Karthik K, Pushparani A, Mahalakshmi A.Study on comparison of tramadol, clonidineanddexmedetomidine for post spinal anesthesia shivering. Rev BrasAnestesiol 2018; 68(1): 42-48.https://doi.org10.1016/j.bjan.2017.04.019.
Eldaba AA, Amr YM. Intravenous granisetron attenuateshypotension during spinal anesthesia in cesarean delivery: Adouble-blind, prospective randomized controlled study. JAesthesiol Clin Pharmacol 2015; 31(3): 329.https://doi.org10.4103/0970-9185.161667.
Eydi M, Golzari SE, Aghamohammadi D, Kolahdouzan K, SafariS, Ostadi Z, et al. Postoperative management of shivering:acomparison of Pethidine vs. Ketamine. Anesth Pain Med 2014;4(2): e15499. https://doi.org10.5812/aapm.15499.
Tie HT, Su GZ, He K, Liang SR, Yuan HW, Mou JH, et al.Efficacy and safety of ondansetron in preventing post anesthesiashivering: A meta-analyses of randomized controlled trials. BMCAnesthesiol 2014; 14(1): 12-15.https://doi.org/10.1186%2F1471-2253-14-12.
Nallam SR, Cherukuru K, Sateesh G. Efficacy of intravenousondansetron for prevention of postspinal shivering during lowersegment cesarean section. Anesth Essays Res 2017; 11(2): 508-513.https://doi.org/10.4103/aer.AER_26_17.
Kelsaka E, Baris S, Karakaya D, Sarihasan B. Comparison ofondansetron and meperidine for prevention of shivering inpatients undergoing spinal anesthesia. Reg Anesth Pain Med2006; 31: 40–45. https://doi.org/10.1016/j.rapm.2005.10.010.
Badawy AA, Mokhtar AM. The role of ondansetron inprevention of post spinal shivering in obstetric patients. Egypt J
Anaesth 2017; 33: 29-30.https://doi.org//10.1016/j.egja.2016.12.004.
Browning RM, Fellingham WH, O’Loughlin EJ, Brown NA,Paech MJ. Prophylactic ondansetron does not prevent shivering
or decrease shivering severity during cesarean delivery undercombined spinal-epidural anesthesia: a randomized trial. Reg
Anesth Pain Med 2013; 38: 39–43.https://doi.org/10.1097/AAP.0b013e31827049c6.
Powell RM, Buggy DJ. Ondansetron given before induction ofanesthesia reduces shivering after general anesthesia. AnesthAnalg 2000; 90(1): 1423-1427.https://doi.org/10.1097/00000539-200006000-00032.
Kim MS, Kim DW, Woo SH, Yon JH, Lee S. Effect of ramosetronon shivering during spinal anesthesia. Korean J Anesthesiol 2010;58: 256–259. https://doi.org/10.4097/kjae.2010.58.3.256.
Sagir O, Gulhas N, Toprak H, Yucel A, Begec Z, Ersoy O, et al.Control of shivering during regional anaesthesia: Prophylacticketamine and granisetron. Acta Anaesthesiol Scand 2007; 51: 44-49. https://doi.org/10.1111/j.1399-6576.2006. 01196.x.
Sajedi P, Yaraghi A, Moseli HA. Efficacy of granisetron inpreventing postanesthetic shivering. Acta Anaesthesiol Taiwan
; 46: 16670. https://doi.org/10.4103/2249-4472.155195.
Narayan S. A comparative study between intravenousOndansetron and Granisetron in attenuation of hypotensionduring spinal anaesthesia in patients undergoing caesareansection. Indian J Clin Anaesth 2020; 7(3): 470-476.https://doi.org//10.18231/j.ijca.2020.085.
Marashi SM, Soltani Omid S, Mohammadi SS, Aghajani Y,Movafegh A. Comparing two different doses of intravenousondansetron with placebo on attenuation of spinal inducedhypotension and shivering. Anesth Pain Med 2014; 4: 12055.https://doi.org/10.5812/aapm.12055.