Comparative study of granisetron versus pethidine for the prevention of perioperative shivering under spinal Anesthesia

Kabade, Savitri D; Venkatesh, Yedatore; Karthik, S. L.; Kumar, Vikas

doi:10.4103/2394-6954.190769

Cited by 11 publications

(13 citation statements)

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“…Kabade et al also concluded that prophylactic granisetron reduces the need of antiemetic's (19). This finding is also largely consistent with the results of our study.…”

Section: Discussionsupporting

confidence: 93%

The effect of granisetron, ondansetron, and pethidine in preventing postoperative shivering: controlled clinical trial

Entezariasl

Zandian

Isazadehfar

2019

Preprint

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Background: recently, use of HT35 receptor antagonists to prevent postoperative shivering has attracted a great deal of attention. Therefore, the present study was conducted with the aim of investigating the effectiveness of granisetron as an HT35 antagonist when compared with ondansetron and pethidine in preventing postoperative shivering.Methods: in this triple blind random clinical trial study, 90 patients 18-50 years of age with ASA Class I and II undergoing general anesthesia were randomly assigned into one of the three drug groups: O (4mg ondansetron), G (40 μg/kg of granisetron), and P (25 mg pethidine), immediately before induction of anesthesia. After anesthesia induction, at the end of the surgery, after the entrance and after leaving the recovery state, central temperature, peripheral temperature, systolic blood pressure, diastolic blood pressure, heart rate, and shivering were measured and recorded. P-value less than 0.05 was considered statistically significant.Results: in the pethidine, ondansetron, and granisetron groups, 4 (13.3%), 3 (10%), and 10 (33.3%) of

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“…Kabade et al also concluded that prophylactic granisetron reduces the need of antiemetic's (19). This finding is also largely consistent with the results of our study.…”

Section: Discussionsupporting

confidence: 93%

The effect of granisetron, ondansetron, and pethidine in preventing postoperative shivering: controlled clinical trial

Entezariasl

Zandian

Isazadehfar

2019

Preprint

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“…The anti-shivering effect of Granisetron (serotonin receptor antagonist), which has role in neurotransmission and thermoregulation suggesting the serotonergic system could be involved in the control of post anesthetic shivering, also 5-hydroxy tryptamine receptor antagonist used as antiemetic's routinely. [29] , Kabade et al [32] compared granisetron to pethidine in prophylaxis of shivering after spinal anesthesia and concluded that, prophylactic administration of granisetron 40 mcg/kg IV is equally effective as pethidine 0.4 mg/kg in prevention of perioperative shivering after spinal anesthesia, maintains core temperature and oxygen saturation levels above that of pethidine. In addition, granisetron also decreases the need of antiemetics.…”

Section: Discussionmentioning

confidence: 99%

A comparative Study Between Pethidine, Granisetron and Tramadol in Prophylaxis Against Perioperative Shivering After Spinal Anesthesia

Abdelsalam

2020

International Journal of Medical Arts

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Background: Peri-operative shivering, a challenging discomfort faced in anesthesiologists' daily practice. Many drugs were used as a prophylaxis, but there was no consensus on ideal or standard drug yet. Aim of the work: To compare the effectiveness and safety of pethidine, granisetron and tramadol in prophylaxis against perioperative shivering after spinal anesthesia. Patients and methods: Sixty adult patients, who underwent spinal anesthesia, were included. They were randomly assigned to granisetron, pethidine or tramadol (20 in each group), and submitted to standard intraoperative monitoring and follow up for postoperative 4 hours. Monitoring included electrocardiography, oxygen saturation, respiratory rate, temperature, non-invasive blood level, conscious level and sedation score. Side effects were documented. Results: Intra-and post-operatively, there was significant reduction of heart rate in granisetron and tramadol groups. Mean arterial pressure significantly decreased in granisetron group at the time from 30 minutes to the end of surgery and during the first two postoperative hours. Respiratory rate significantly decreased in pethidine group during the complete intra-and post-operative period. Granisetron had no sedative effect at all, but sedation was significantly increased among pethidine group. Finally, perioperative shivering was reported in 25%, 15% and 15% of pethidine, granisetron and tramadol groups respectively. Nausea/vomiting was reported in 20%, 10.0%, and 0% of pethidine, tramadol and granisetron groups respectively. Pruritus was confined to 30% pethidine group with significant difference. Conclusion: Granisetron, tramadol and pethidine, all are effective as a prophylaxis against perioperative shivering after spinal anesthesia. However, granisetron seems to be the most suitable drug.

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“…Shivering is defined as an involuntary, repetitive activity of skeletal muscles to raise the core body temperature ( 1 – 5 ). Spinal anesthesia is known to decrease the shivering threshold, preceded by core hypothermia and vasoconstriction above the level of the block ( 6 ). The review of 21 studies reported that the median incidence of shivering related to neuraxial anesthesia was 55% in ranges of 40% to 64% ( 7 ).…”

Section: Introductionmentioning

confidence: 99%

The effects of intravenous tramadol vs. intravenous ketamine in the prevention of shivering during spinal anesthesia: A meta-analysis of randomized controlled trials

et al. 2022

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BackgroundShivering is a common complication after subarachnoid administration of local anesthetics. Intravenous ketamine and tramadol are widely available anti-shivering drugs, especially in developing settings. This meta-analysis aimed to compare the effects of intravenous ketamine vs. tramadol for post-spinal anesthesia shivering.Materials and methodsPubMed/MEDLINE, Web of Science, Cochrane Library, Embase, and Google Scholar databases were used to search for relevant articles for this study. Mean difference (MD) with 95% confidence interval (CI) was used to analyze continuous outcomes, and risk ratio (RR) with 95% CI to analyze categorical results. The heterogeneity of the included studies was assessed using the I2 test. We utilized Review Manager 5.4.1 to perform statistical analysis.ResultsThirteen studies involving 1,532 patients were included in this meta-analysis. Ketamine had comparable effects in preventing post-spinal anesthetics shivering [RR = 1.06; 95% CI (0.94, 1.20), P = 0.33, I2 = 77], and onset of shivering [MD = −0.10; 95%CI (– 2.68, 2.48), P = 0.94, I2 = 0%], lower incidences of nausea and vomiting [RR = 0.51; 95%CI (0.26, 0.99), P = 0.05, I2 = 67%], and lower incidences of bradycardia [RR = 0.16; 95%CI (0.05, 0.47), P = 0.001, I2 = 33%], higher incidence of hallucinations [RR = 12; 95%CI (1.58, 91.40), P = 0.02, I2 = 0%], and comparable effects regarding the incidences of hypotension [RR = 0.60; 95%CI (0.30, 1.21), P = 0.15, I2 = 54%] as compared to tramadol.ConclusionsIntravenous ketamine and tramadol are comparable in the prevention of post-spinal anesthetic shivering. Ketamine had a better outcome with less occurrences of nausea, vomiting, and bradycardia. However, ketamine was associated with higher incidences of hallucinations than tramadol.

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Comparative study of granisetron versus pethidine for the prevention of perioperative shivering under spinal Anesthesia

Cited by 11 publications

References 0 publications

The effect of granisetron, ondansetron, and pethidine in preventing postoperative shivering: controlled clinical trial

The effect of granisetron, ondansetron, and pethidine in preventing postoperative shivering: controlled clinical trial

A comparative Study Between Pethidine, Granisetron and Tramadol in Prophylaxis Against Perioperative Shivering After Spinal Anesthesia

The effects of intravenous tramadol vs. intravenous ketamine in the prevention of shivering during spinal anesthesia: A meta-analysis of randomized controlled trials

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