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A randomized, comparative study of prophylactic intravenous acetaminophen, dexamethasone and pethidine regarding the incidence of post spinal anesthesia shivering in lower limb orthopedic surgeries
Author(s):
1. Mohamed Medhat Moustafa Kamal Nouh: Faculty of Medicine, Ain Shams University,Nasr City, Cairo,Egypt
2. Galal Adel Mohamed Abd Elrehiem Elkadi: Faculty of Medicine, Ain Shams University,Nasr City, Cairo,Egypt
3. Eman Mohamed Kamal Aboseif: Faculty of Medicine, Ain Shams University,Nasr City, Cairo,Egypt
4. Faisal Said Abd El Hamid: Faculty of Medicine, Ain Shams University,Nasr City, Cairo,Egypt
5. Marwa Mostafa Mohamed Ali Mowafi: Faculty of Medicine, Ain Shams University,Nasr City, Cairo,Egypt
Abstract:
Background: Currently, there is a lack of an established standard or protocol for the management of post-spinal anesthesia shivering (PSAS). We compared the efficacy of intravenous use of three drugs, e.g., acetaminophen, dexamethasone, and pethidine in prevention of PSAS. Methodology: We included 108 patients who were randomly assigned to three equal groups of 36 patients each. Group A patients received pethidine infusion at 0.5 mg/kg; Group B patients were infused with acetaminophen 15 mg/kg and Group C was given dexamethasone infusion at 0.1 mg/kg. The degree of shivering at its onset was determined using the Bedside Shivering Assessment Scale (BSAS). Data was analyzed using Statistical Package for Social Science (SPSS) version 22. Results: PSAS was observed in 10 (27.7 %) patients in Group A vs. 14 (38.8 %) patients in Group B (P = 0.32), and 21 (58.3 %) patients of Group C (P = 0.01). The P-value between B vs C was 0.10, and between all the groups was 0.03. The BSAS score was 26 in Group A (75% patients out of 36 did not develop shivering), 22 in Group B, and 15 in Group C. The P-value between A vs. B was 0.01, A vs. C = 0.01, B vs. C = 0.12, and between all groups was 0.02. Conclusion: Aacetaminophen was more effective than dexamethasone, while pethidine was more effective than both, acetaminophen as well as dexamethasone, in decreasing the incidence of post-spinal anesthesia shivering. Trial Registry: ClinicalTrials.gov ID: NCT05284409 
Page(s): 185-190
Published: Journal: Anaesthesia, Pain and Intensive Care, Volume: 27, Issue: 2, Year: 2023
Keywords:
Acetaminophen , Dexamethasone , Shivering , Post spinal , Pethidine
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