Comparative Efficacy Of Prophylactic Ketamine, Pethidine, And Placebo In Preventing Postoperative Shivering Following General Anaesthesia: A Randomized Double-Blind Study
Main Article Content
Abstract
Among individuals with cardiovascular disease histories, postoperative shivering is associated with an increased risk of complications. In the study, low-dose prophylactic ketamine, pethidine, or a placebo were compared to prevent postoperative shivering. Various treatment options were compared among 90 randomly selected patients: saline, pethidine, and ketamine. The recovery period was characterized by shivering rates of 0.10, 0.10, 0.20, and 0.30. Neither dose of pethidine nor ketamine produced shivering at T0 or T10. However, neither treatment differed significantly at T30. Despite pethidine's effectiveness, ketamine failed to demonstrate any benefit despite its effectiveness. We found that both drugs were highly tolerated, and no severe adverse reactions occurred. Developing a simplified dosing regimen will require future research.
Article Details
References
Singh P, Dimitriou V, Mahajan RP, Crossley AWA. Doubleblind comparison between doxapram and pethidine in the treatment of postanaesthetic shivering. Br J Anaesth 1993; 71: 685–8
Horn EP, Werner C, Sessler DI, Steinfath M, Schulte am Esch J. Late intraoperative clonidine administration prevents postanesthetic shivering after total intravenous or volatile anesthesia. Anesth Analg 1997; 84: 613–17
Mathews S, Al Mulla A, Varghese PK, Radim K, Mumtaz S. Postanaesthetic shivering–a new look at tramadol. Anaesthesia 2002; 57: 394–8
Piper SN, Suttner SW, Schmidt CC, Maleck WH, Kumle B, Boldt J. Nefopam and clonidine in the prevention of postanaesthetic shivering. Anaesthesia 1999; 54: 695–9
Vanderstappen I, Vandermeerch E, Vanacker B, Mattheussen M, Herijgers P, Van Aken H. The effect of prophylactic clonidine on postoperative shivering: a large prospective double-blind study. Anaesthesia 1996; 51: 351– 5
Wrench IJ, Cavill G, Ward JEH, Crossley AWA. Comparison between alfentanil, pethidine and placebo in the treatment of post-anaesthetic shivering. Br J Anaesth 1997; 79: 541–2
Terasako K, Yamamoto M. Comparison between pentazocine, pethidine and placebo in the treatment of post- anaesthetic shivering. Acta Anaesthesiol Scand 2000; 44: 311–2
De Witte J, Sessler DI. Perioperative shivering: physiology and pharmacology. Anesthesiology 2002; 96: 467–84
Sharma DR, Thakur JR. Ketamine and shivering. Anaesthesia 1990; 45: 252–3
Sessler DI, Israel D, Pozos RS, Pozos M, Rubinstein EH. Spontaneous post-anesthetic tremor does not resemble thermoregulatory shivering. Anesthesiology 1988; 68: 843–50
Monso A, Riudeubas J, Barbal F, Laporte JR, Arnau JM. A randomized, double-blind, placebo-controlled trial comparing pethidine to metamizol for treatment of post-anaesthetic shivering. Br J Clin Pharmacol 1996; 42: 307–11
Kranke P, Eberhart LH, Roewe N, Tramer MR. Pharmacological treatment of postoperative shivering: A quantitative systematic rview of randomized controlled trials. Anesth Analg 2002; 94: 453–60