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Effect of Prophylactic Intrathecal Pethidine on the Incidence of Shivering on Mothers Undergoing Cesarean Section Under Spinal Anesthesia: A Randomized Controlled Trial

BACKGROUND: Shivering is the most common and unpleasant complication of anesthesia with an incidence of 70.7% in cesarean section done under spinal anesthesia which is associated with cardiovascular and respiratory complications. Even though it causes such devastating complications; the prevention o...

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Autores principales: Girma, Timsel, Alemu, Wagaye, Assen, Sofia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9365984/
https://www.ncbi.nlm.nih.gov/pubmed/35966870
http://dx.doi.org/10.3389/fmed.2022.887724
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author Girma, Timsel
Alemu, Wagaye
Assen, Sofia
author_facet Girma, Timsel
Alemu, Wagaye
Assen, Sofia
author_sort Girma, Timsel
collection PubMed
description BACKGROUND: Shivering is the most common and unpleasant complication of anesthesia with an incidence of 70.7% in cesarean section done under spinal anesthesia which is associated with cardiovascular and respiratory complications. Even though it causes such devastating complications; the prevention of shivering is not well investigated. This study aimed to assess the effect of intrathecal pethidine on the incidence and severity of shivering in patients undergoing cesarean section under Spinal anesthesia. MATERIALS AND METHODS: After obtaining ethical clearance double-blinded single centered a randomized controlled trial was conducted in a total of 86 pregnant mothers who were randomly allocated into two groups by computer-generated random number. Approximately 1 ml of 10 mg preservative-free pethidine was added to 12.5 mg of 0.5% bupivacaine for spinal anesthesia in the treatment group and 12.5 mg of 0.5% bupivacaine alone was given in the control group. Incidence and severity of shivering, as well as adverse effect was recorded intraoperatively, in post-anesthesia care unit (PACU) and ward. Independent sample t-test, Mann–Whitney U test and chi-square were used for analysis. A p-value less than 0.05 was considered statistically significant. RESULTS: Shivering was observed in 53.5 and 20.9% in the control and treatment groups, respectively, which was statistically significant with p = 0.002. The risk of developing shivering was reduced by 61% in the treatment group with (RR = 0.39 and CI of 0.205–0.745); the intensity of shivering was also higher in the control group than in the treatment group with p = 0.004. Considering an adverse effect, the incidence of PONV was not significantly different between with p > 0.05 while the incidence of pruritus was higher in the treatment group than the control group with p = 0.003. CONCLUSION: Adding 10 mg of preservative free pethidine intrathecally during spinal anesthesia is effective in reducing incidence and severity of shivering, without causing significant adverse effects on mother.
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spelling pubmed-93659842022-08-12 Effect of Prophylactic Intrathecal Pethidine on the Incidence of Shivering on Mothers Undergoing Cesarean Section Under Spinal Anesthesia: A Randomized Controlled Trial Girma, Timsel Alemu, Wagaye Assen, Sofia Front Med (Lausanne) Medicine BACKGROUND: Shivering is the most common and unpleasant complication of anesthesia with an incidence of 70.7% in cesarean section done under spinal anesthesia which is associated with cardiovascular and respiratory complications. Even though it causes such devastating complications; the prevention of shivering is not well investigated. This study aimed to assess the effect of intrathecal pethidine on the incidence and severity of shivering in patients undergoing cesarean section under Spinal anesthesia. MATERIALS AND METHODS: After obtaining ethical clearance double-blinded single centered a randomized controlled trial was conducted in a total of 86 pregnant mothers who were randomly allocated into two groups by computer-generated random number. Approximately 1 ml of 10 mg preservative-free pethidine was added to 12.5 mg of 0.5% bupivacaine for spinal anesthesia in the treatment group and 12.5 mg of 0.5% bupivacaine alone was given in the control group. Incidence and severity of shivering, as well as adverse effect was recorded intraoperatively, in post-anesthesia care unit (PACU) and ward. Independent sample t-test, Mann–Whitney U test and chi-square were used for analysis. A p-value less than 0.05 was considered statistically significant. RESULTS: Shivering was observed in 53.5 and 20.9% in the control and treatment groups, respectively, which was statistically significant with p = 0.002. The risk of developing shivering was reduced by 61% in the treatment group with (RR = 0.39 and CI of 0.205–0.745); the intensity of shivering was also higher in the control group than in the treatment group with p = 0.004. Considering an adverse effect, the incidence of PONV was not significantly different between with p > 0.05 while the incidence of pruritus was higher in the treatment group than the control group with p = 0.003. CONCLUSION: Adding 10 mg of preservative free pethidine intrathecally during spinal anesthesia is effective in reducing incidence and severity of shivering, without causing significant adverse effects on mother. Frontiers Media S.A. 2022-07-28 /pmc/articles/PMC9365984/ /pubmed/35966870 http://dx.doi.org/10.3389/fmed.2022.887724 Text en Copyright © 2022 Girma, Alemu and Assen. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Girma, Timsel
Alemu, Wagaye
Assen, Sofia
Effect of Prophylactic Intrathecal Pethidine on the Incidence of Shivering on Mothers Undergoing Cesarean Section Under Spinal Anesthesia: A Randomized Controlled Trial
title Effect of Prophylactic Intrathecal Pethidine on the Incidence of Shivering on Mothers Undergoing Cesarean Section Under Spinal Anesthesia: A Randomized Controlled Trial
title_full Effect of Prophylactic Intrathecal Pethidine on the Incidence of Shivering on Mothers Undergoing Cesarean Section Under Spinal Anesthesia: A Randomized Controlled Trial
title_fullStr Effect of Prophylactic Intrathecal Pethidine on the Incidence of Shivering on Mothers Undergoing Cesarean Section Under Spinal Anesthesia: A Randomized Controlled Trial
title_full_unstemmed Effect of Prophylactic Intrathecal Pethidine on the Incidence of Shivering on Mothers Undergoing Cesarean Section Under Spinal Anesthesia: A Randomized Controlled Trial
title_short Effect of Prophylactic Intrathecal Pethidine on the Incidence of Shivering on Mothers Undergoing Cesarean Section Under Spinal Anesthesia: A Randomized Controlled Trial
title_sort effect of prophylactic intrathecal pethidine on the incidence of shivering on mothers undergoing cesarean section under spinal anesthesia: a randomized controlled trial
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9365984/
https://www.ncbi.nlm.nih.gov/pubmed/35966870
http://dx.doi.org/10.3389/fmed.2022.887724
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