• K S Ram Kiran and Kalyani Surya Dhana Lakshmi Sangineni.
• Department of Anaesthesiology, ESIC Medical College and Hospital, Hyderabad, Telangana, India.
• Anesth Essays Res. 2019 Jan 1; 13 (1): 19-24.

ContextPerioperative shivering can occur in up to 85% of patients undergoing cesarean section under spinal anesthesia. It has many detrimental effects and disrupts early mother-child bonding. Therefore, it should ideally be prevented by either pharmacologic or nonpharmacological means.AimsThe primary aim of this study was to evaluate the efficacy of intraoperative forced-air warming, ondansetron or their combination in preventing perioperative shivering in patients undergoing elective cesarean section under spinal anesthesia.Settings And DesignA prospective randomized controlled comparative study done at the tertiary care center.Subjects And MethodsA total of 120 patients undergoing elective cesarean section under spinal anesthesia were randomly assigned to three groups. Group O received ondansetron 4 mg intravenously (i.v.) after giving block with no forced air warming. Group W received forced-air warming intraoperatively. Group C received ondansetron 4 mg i.v. after giving block plus intraoperative forced-air warming. Core temperature (tympanic membrane) and the arm skin temperature were measured and shivering was graded simultaneously.Statistical Analysis UsedParametric data were analyzed using one-way ANOVA and Student's paired t-test where ever appropriate. Nonparametric data were analyzed using the Kruskal-Wallis and the Chi-square test. Values of P < 0.05 were considered statistically significant.ResultsShivering incidence was higher in Group O and Group W being 17.5% and 20%, respectively, and least in Group C being 5%. The incidence of Grade ≥3 shivering requiring rescue drug was lower in Group C (2.5%) compared to that of the Groups W (5%) and O (10%) but was not statistically significant (P = 0.21).ConclusionsCombined use of ondansetron and forced- air warmer was more effective in reducing the incidence of shivering in pregnant women during elective cesarean section than when used individually.

5 keywords...

hide…