Comparative study of the prophylactic effects of intravenous injection of dexmedetomidine, ondansetron, and pethidine on postoperative shivering of abdominal surgery under general anesthesia: A randomized clinical trial

Document Type : Original Article

Authors
Mitra Jabalameli 1
Behzad Nazemroaya 2
Mahsa Heydari 3
1 Department of Anesthesiology, Isfahan University of Medical Sciences, Isfahan, Iran
2 Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
3 Department of Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
Background: postoperative shivering is a common complication of various surgical, so far no acceptable theory has been presented on the prevention of it. The aim of this study was to compare the effect of intravenous injection of dexmedetomidine, ondansetron, and pethidine on postoperative shivering among patients under abdominal surgery. Materials and Methods: In a double-blind clinical trial study, 128 patients undergoing abdominal surgery were selected and randomly divided into four groups of 32. In the 4 groups, 0.5 μg/kg dexmedetomidine, 0.5 mg/kg pethidine, 0.1 mg/kg ondansetron, and the same volume of normal saline were injected intravenously when anesthetics were discontinued and the incidence and severity of postoperative shivering were determined and compared in four groups. Results: The incidence of postoperative shivering was 12.5% in the dexmedetomidine group, 31.3% in the ondansetron group, 31.3% in the pethidine group, and 50% in the control group (P = 0.015). The mean of shivering severity in the four groups was 1.33 ± 0.5, 0.17 ± 0.8, 1.09 ± 0.4, and 1.13 ± 0.39, and the difference between the four groups was significant (P = 0.005). Conclusion: The use of all three drugs of dexmedetomidine, ondansetron, and pethidine is effective in decreasing the incidence of postoperative shivering, but the use of dexmedetomidine is associated with less postoperative shivering, better hemodynamic stability, and fewer other postoperative complications.

Keywords

1.
Teymourian H, Mohajerani SA, Bagheri P, Seddighi A, Seddighi AS, Razavian I. Effect of ondansetron on postoperative shivering after craniotomy. World Neurosurg 2015;84:1923-8.  Back to cited text no. 1
    
2.
Sajedi P, Nazemroaya B. Comparing the effectiveness of antishivering action of meperidine alfentanil, sufentanil, fentanyl and tramadol after general anesthesia. Shiraz E-Med J 2006;7:20409.  Back to cited text no. 2
    
3.
Parsa T, Dabir S, Radpay B. Efficacy of pethidine and buprenorphine for prevention and treatment of postanesthetic shivering. Tanaffos 2007;6:54-8.  Back to cited text no. 3
    
4.
Edwards DJ, Svensson CK, Visco JP, Lalka D. Clinical pharmacokinetics of pethidine: 1982. Clin Pharmacokinet 1982;7:421-33.  Back to cited text no. 4
    
5.
Mather LE, Meffin PJ. Clinical pharmacokinetics of pethidine. Clin Pharmacokinet 1978;3:352-68.  Back to cited text no. 5
    
6.
Milne RJ, Heel RC. Ondansetron. Therapeutic use as an antiemetic. Drugs 1991;41:574-95.  Back to cited text no. 6
    
7.
Bae HB. Dexmedetomidine: An attractive adjunct to anesthesia. Korean J Anesthesiol 2017;70:375-6.  Back to cited text no. 7
    
8.
Kim YS, Kim YI, Seo KH, Kang HR. Optimal dose of prophylactic dexmedetomidine for preventing postoperative shivering. Int J Med Sci 2013;10:1327-32.  Back to cited text no. 8
    
9.
Hakim M, Walia H, Dellinger HL, Balaban O, Saadat H, Kirschner RE, et al. The effect of operating room temperature on the performance of clinical and cognitive tasks. Pediatr Qual Saf 2018;3:e069.  Back to cited text no. 9
    
10.
He K, Zhao H, Zhou HC. Efficiency and safety of ondansetron in preventing postanaesthesia shivering. Ann R Coll Surg Engl 2016;98:358-66.  Back to cited text no. 10
    
11.
Entezari Asl M, Isazadehfar Kh, Akhavanakbari G, Khoshbaten M. The effect of ondansetron in prevention of postoperative shivering after general anesthesia in gynecological surgery. Iran Red Crescent Med J 2012;14:316-7.  Back to cited text no. 11
    
12.
Abdel-Ghaffar HS, Mohamed SA, Fares KM, Osman MA. Safety and efficacy of dexmedetomidine in treating post spinal anesthesia shivering: a randomized clinically controlled dose-finding trial. Pain Physician 2016;19:243-53.  Back to cited text no. 12
    
13.
Thomas A, Satyaprakash MV, Elakkumanan LB, Bidkar PU, Mishra SK. Comparison of different regimens of intravenous dexmedetomidine on duration of subarachnoid block. J Anaesthesiol Clin Pharmacol 2016;32:497-500.  Back to cited text no. 13
[PUBMED]  [Full text]  
14.
Doufas AG, Lin CM, Suleman MI, Liem EB, Lenhardt R, Morioka N, et al. Dexmedetomidine and meperidine additively reduce the shivering threshold in humans. Stroke 2003;34:1218-23.  Back to cited text no. 14
    
15.
Nasseri K, Ghadami N, Nouri B. Effects of intrathecal dexmedetomidine on shivering after spinal anesthesia for cesarean section: A double-blind randomized clinical trial. Drug Des Devel Ther 2017;11:1107-13.  Back to cited text no. 15
    
16.
Bicer C, Esmaoglu A, Akin A, Boyaci A. Dexmedetomidine and meperidine prevent postanaesthetic shivering. Eur J Anaesthesiol 2006;23:149-53.  Back to cited text no. 16
Advanced Biomedical Research
Volume 2021, December
December 2021
Pages 1-6