Intrathecal Meperidine Plus Lidocaine for Prevention of Shivering during Cesarean Section
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background: Shivering related to spinal anesthesia may interfere with monitoring and is uncomfortable. The aim of the present study was to investigate low-dose intrathecal meperidine for the prevention of shivering after induction of spinal anesthesia in parturients with cesarean section.Methods: This was a prospective randomized, double-blind, placebo-controlled trial including 100 parturients, of American Society of Anesthesiologists (ASA) physical status I or II, scheduled for elective cesarean section under spinal anesthesia who were randomly assigned to a meperidine (0.2 mg/kg) plus hyperbaric lidocaine (5%, 75 mg, n = 50; group M) group or a placebo plus hyperbaric lidocaine (5%, 75 mg, n = 50; group L) group. Demographic and surgical data, adverse events, and the mean intensity for each parturient were assessed during the entire study period by a blinded observer.Results: There were no significant differences between the two study groups regarding the demographic and surgical data (P ＞ 0.05). The incidence of shivering during the entire study period significantly decreased in the group of parturients who received intrathecal meperidine (P = 0.04). There were no significant differences in nausea and vomiting between the two groups.Conclusions: Low-dose intrathecal meperidine (10 mg) is safe and effective in reducing the incidence and severity of shivering associated with spinal anesthesia in parturients with cesarean section.
Abstract
Background: Shivering related to spinal anesthesia may interfere with monitoring and is uncomfortable. The aim of the present study was to investigate low-dose intrathecal meperidine for the prevention of shivering after induction of spinal anesthesia in parturients with cesarean section.Methods: This was a prospective randomized, double-blind, placebo-controlled trial including 100 parturients, of American Society of Anesthesiologists (ASA) physical status I or II, scheduled for elective cesarean section under spinal anesthesia who were randomly assigned to a meperidine (0.2 mg/kg) plus hyperbaric lidocaine (5%, 75 mg, n = 50; group M) group or a placebo plus hyperbaric lidocaine (5%, 75 mg, n = 50; group L) group. Demographic and surgical data, adverse events, and the mean intensity for each parturient were assessed during the entire study period by a blinded observer.Results: There were no significant differences between the two study groups regarding the demographic and surgical data (P ＞ 0.05). The incidence of shivering during the entire study period significantly decreased in the group of parturients who received intrathecal meperidine (P = 0.04). There were no significant differences in nausea and vomiting between the two groups.Conclusions: Low-dose intrathecal meperidine (10 mg) is safe and effective in reducing the incidence and severity of shivering associated with spinal anesthesia in parturients with cesarean section.
참고문헌 (30)
- Ciofolo MJ, "Changes in ventilation, oxygen uptake, and carbon dioxide output during recovery from isoflurane anesthesia", Anesthesiology, 70, pp.737~741 (1989)
- Kurz A, "Thermoregulatory response thresholds during spinal anesthesia", Anesth Analg, 77, pp.721~726 (1993)
- 한승엽, "The Effect of Low-dose Ketamine on Post-caesarean Delivery Analgesia after Spinal Anesthesia", The Korean Journal of Pain, 26(3), pp.270~276 (2013), 대한통증학회
- Matsukawa T, "Heat flow and distribution during epidural anesthesia", Anesthesiology, 83, pp.961~967 (1995)
- Cheol Lee, "Circadian Effects on Neural Blockade of Intrathecal Hyperbaric Bupivacaine", The Korean Journal of Pain, 23(3), pp.186~189 (2010), 대한통증학회
- Crowley LJ, "Shivering and neuraxial anesthesia", Reg Anesth Pain Med, 33, pp.241~252 (2008)
- 한재원, "제왕절개술을 위한 척추마취시 척수강내 투여된 fentanyl과 meperidine이 마취후 전율에 미치는 효과 비교", Korean Journal of Anesthesiology, 52(6), pp.657~662 (2007), 대한마취통증의학회
- Alfonsi P, "The effects of pethidine, fentanyl and lignocaine on postanaesthetic shivering", Anaesthesia, 50, pp.214~217 (1995)
- Alfonsi P, "The effects of meperidine and sufentanil on the shivering threshold in postoperative patients", Anesthesiology, 89, pp.43~48 (1998)
- Kurz M, "Naloxone, meperidine, and shivering", Anesthesiology, 79, pp.1193~1201 (1993)
- Delaunay L, "Clonidine comparably decreases the thermoregulatory thresholds for vasoconstriction and shivering in humans", Anesthesiology, 79, pp.470~474 (1993)
- Fukuda K, "Intravenous opioid anesthetics, In Miller's anesthesia. 6th ed", pp.379~438 (2005), Elsevier Churchill Livingstone
- Casey WF, "Intravenous meperidine for control of shivering during caesarean section under epidural anaesthesia", Can J Anaesth, 35, pp.128~133 (1988)
- Chen JC, "Intrathecal meperidine attenuates shivering induced by spinal anesthesia", Ma Zui Xue Za Zhi, 31, pp.19~24 (1993)
- Roy JD, "Intrathecal meperidine decreases shivering during cesarean delivery under spinal anesthesia", Anesth An, 98, pp.230~234 (2004)
- Hong JY, "Comparison of the effects of intrathecal morphine and pethidine on shivering after Caesarean delivery under combined-spinal epidural anaesthesia", Anaesthesia, 60, pp.1168~1172 (2005)
- Khan ZH, "Antishivering effects of two different doses of intrathecal meperidine in caesarean section: a prospective randomised blinded study", Eur J Anaesthesiol, 28, pp.202~206 (2011)
- Crossley AW, "The intensity of postoperative shivering is unrelated to axillary temperature", Anaesthesia, 49, pp.205~207 (1994)
- Horn EP, "Postoperative pain facilitates nonthermoregulatory tremor", Anesthesiology, 91, pp.979~984 (1999)
- Mahajan RP, "Intraocular pressure changes during muscular hyperactivity after general anesthesia", Anesthesiology, 66, pp.419~421 (1987)
- de Courcy JG, "Artefactual 'hypotension' from shivering", Anaesthesia, 44, pp.787~788 (1989)
- Barker SJ, "The effects of motion on the performance of pulse oximeters in volunteers (revised publication)", Anesthesiology, 86, pp.101~108 (1997)
- Just B, "Oxygen uptake during recovery following naloxone. Relationship with intraoperative heat loss", Anesthesiology, 76, pp.60~64 (1992)
- Jones HD, "Posoperative shvering and hypoxaemia after halothane, nitrous oxide and oxygen anaesthesia", Br J Anaesth, 37, pp.35~41 (1965)
- Pflug AE, "Prevention of post-anaesthesia shivering", Can Anaesth Soc J, 25, pp.43~49 (1978)
- Entezari Asl M, "The effect of ondansetron in prevention of postoperative shivering after general anesthesia in gynecological surgery", Iran Red Crescent Med J, 14, pp.316~317 (2012)
- Shoar S, "Efficacy of acupuncture in prevention of postoperative anaesthesia-related shivering", Acupunct Med, 31, pp.120~121 (2013)
- Horn EP, "Late intraoperative clonidine administration prevents postanesthetic shivering after total intravenous or volatile anesthesia", Anesth Analg, 84, pp.613~617 (1997)
- Stoelting RK, "Pharmacology & physiology in anesthetic practice. 4th ed", pp.864~ (2006), Lippincott Williams & Wilkins
- Kurz A, "Meperidine decreases the shivering threshold twice as much as the vasoconstriction threshold", Anesthesiology, 86, pp.1046~1054 (1997)