Comparison of meperidine and nefopam for prevention of shivering during spinal anesthesia

Kim, Yeon A; Kweon, Tae Dong; Kim, Myounghwa; Lee, Hyein; Lee, You Jin; Lee, Ki Young

doi:10.4097/kjae.2013.64.3.229

Cited by 28 publications

(25 citation statements)

References 24 publications

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“…Many drugs, including clonidine, dexmedetomidine, tramadol, alfentanyl, and meperidine, have been used to reduce the uncomfortable effects of shivering and prevent shivering related to anesthesia. Although these drugs reduce shivering, they have side effects such as hypotension, bradycardia, sedation, nausea, vomiting, dry mouth, itching, and respiratory depression [3456]. …”

Section: Discussionmentioning

confidence: 99%

“…When nefopam is administered intravenously, a single 20 mg dose should be infused slowly over 15 to 20 minutes to prevent adverse effects such as nausea, cold sweating, dizziness, tachycardia, drowsiness, and injection pain [7]. While the optimum dose of nefopam to prevent shivering has not been determined, Kim et al [6] demonstrated that nefopam at a dose of 0.15 mg/kg provided anti-shivering effects equivalent to that of meperidine. Based on these studies, we chose a dose of 0.15 mg/kg of nefopam administered over 30 minutes to minimize adverse effects and to match the time with the EA group.…”

Section: Discussionmentioning

confidence: 99%

“…Many pharmacological agents have been used to prevent postanesthetic shivering, but side effects including hypotension, bradycardia, sedation, and respiratory depression have been reported with their use [3456]. Nefopam is a non-narcotic, non-steroidal, centrally acting analgesic [7], that reduces the shivering-threshold, but does not affect the sweating or vasoconstriction thresholds.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of effect of electroacupuncture and nefopam for prevention of postanesthetic shivering in patients undergoing urologic operation under spinal anesthesia

Hong

Kim

Hwang

2016

Korean J Anesthesiol

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BackgroundShivering during spinal anesthesia is a frequent complication and is induced by the core-to-peripheral redistribution of heat. Nefopam has minimal side effects and prevents shivering by reducing the shivering threshold. Electroacupuncture is known to prevent shivering by preserving the core body temperature. We compared the efficacies of electroacupuncture and nefopam for the prevention of shivering during spinal anesthesia.MethodsNinety patients scheduled for elective urological surgery under spinal anesthesia were enrolled in the study. Patients were randomly divided into the control group (Group C, n = 30), the electroacupuncture group (Group A, n = 30), and the nefopam group (Group N, n = 30). Groups C and A received 100 ml of isotonic saline intravenously for 30 minutes before spinal anesthesia, while Group N received nefopam (0.15 mg/kg) mixed in 100 ml of isotonic saline. Group A received 30 minutes of electroacupuncture before receiving anesthesia. Shivering scores, mean arterial pressure, heart rate, body temperature and side effects were recorded before, and at 5, 15, 30, and 60 minutes after spinal anesthesia.ResultsThe incidence of postanesthetic shivering was significantly lower in Group N (10 of 30) and Group A (4 of 30) compared with that in Group C (18 of 30)(P < 0.017). Body temperature was higher in Group N and Group A than in Group C (P < 0.05). Hemodynamic parameters were not different among the groups.ConclusionsBy maintaining body temperature during spinal anesthesia, electroacupuncture is as effective as nefopam in preventing postanesthetic shivering.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison of effect of electroacupuncture and nefopam for prevention of postanesthetic shivering in patients undergoing urologic operation under spinal anesthesia

Hong

Kim

Hwang

2016

Korean J Anesthesiol

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“…Bilotta et al [10] first reported that nefopam was superior to tramadol for the prevention of shivering during neuraxial anesthesia. Also, Piper et al [13] reported that nefopam is better than clonidine for the prevention of postanesthetic shivering whereas Kim et al reported that prophylactic administration of nefopam reduces the incidences and scores of shivering during spinal anesthesia similar to meperidine [14]. Furthermore, nefopam maintained heart rate and mean arterial pressure and this is not surprising as nefopam is known to have positive inotropic and chronotropic effects.…”

Section: Discussionmentioning

confidence: 99%

Dexmedetomidine versus Nefopam for the management of post-spinal anesthesia shivering: A randomized double-blind controlled study

Mohamed

2015

Egyptian Journal of Anaesthesia

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Background: This study is designed to evaluate the relative efficacy of intravenously administered dexmedetomidine and nefopam for control of intraoperative shivering following spinal anesthesia. Materials and methods: A prospective, randomized, double-blind, controlled study was conducted on 100 ASA grade I and II patients of either sex, aged 18-60 years, scheduled for elective lower abdominal and lower limb surgeries, under spinal anesthesia. Patients who developed post-spinal anesthesia shivering of grade 3 or 4 were included in the study, and randomly allocated to one of two groups, group D (n = 50), received Dexmedetomidine in a dose of 0.5 lg/kg diluted in 10 ml isotonic saline slowly I.V. (one minute duration), and group N (n = 50), received Nefopam in a dose of 0.15 mg/kg diluted in 10 ml isotonic saline slowly I.V. (one minute duration) when shivering was observed. Time taken for control of shivering, response rate, recurrence rate, hemodynamics, time to first request of rescue analgesic, one-patient cost and adverse effects were recorded. Results: The time taken for control of shivering was statistically significantly shorter in Nefopam group (group N) compared with dexmedetomidine group (group D). The average time taken for disappearance of shivering was 2.35 ± 0.67 min in group N compared with group D (4.63 ± 1.19 min) (p = 0.041). Patients with incomplete response were more in group D (two patients in group D compared with nil in group N), but not statistically significant and recurrence rate was one patient in group D compared with nil in group N. Time to first request to rescue analgesic was significantly prolonged in group N (351.24 ± 19.71 min) compared with group D (192.63 ± 9.08 min). One-patient cost was significantly lesser in group N (about two £/patient) compared with group D (about 168 £/patient). Adverse effects such as bradycardia, hypotension and sedation were observed in Dexmedetomidine group, while pain at injection was noted in Nefopam group. Conclusion: Nefopam is better as compared to dexmedetomidine for control of intraoperative shivering under spinal anesthesia due to its rapid onset, higher response rate, no sedation, lesser hemodynamic alterations, lesser requirements of rescue analgesics and lesser costs.

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“…A. Kim et al, 2013). Although Tramadole and Pethidine are available drugs for prevention of POS, however, both drugs could increase intra cranial pressure (ICP) and increase risk of seizure.…”

Section: Introductionmentioning

confidence: 99%

Effect of Preemptive Clonidnine Versus Pethidine and Ketamine on Postoperative Shivering During Spinal Anesthesia

Ghasemi¹,

Behnaz²,

Mad³

2017

JMBR

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Introduction: Postoperative Shivering is an early postoperative complication. Incidence of postoperative shivering (POS) following surgeries varies between 20 to 60%. There is still no consensus on treatment modalities especially in opioid-dependent patients. Aim: To compare the effect of preemptive clonidine, ketamin and pethidine in controlling postoperative shivering in addicted patients who undergo spinal anesthesia. Methods: In a clinical trial, 81 patients who underwent spinal anesthesia for elective orthopaedic surgery for lower limb were enrolled and assigned to groups of 27 patients of the study based on accidental numbers, and 2 patients in Pethidine group and 2 patients in ketamine group were excluded from the study. Clonidine 2 mg was administered orally prior to surgery. Ketamin 2mg/kg and pethidine 0.5 mg/kg were administered in recovery to the patients. Postoperative shivering was measured in patients during stay in post anethesia care unit. Blood pressure and heart rate was recorded during 30 minutes after spinal anethesia in operating room. Results: No significant differences in blood pressure and heart rate were observed between patients. Incidence of postoperative shivering was 28% in clonidine, 36% in pethidine and 48% in ketamin group. Risk of shivering was significantly reduced in patients received clonidine in compare to ketamine (RR: 0.34, 95% CI: 0.138-0.856, p=0.022) which was significant and compare to pethidine (RR=0.79, 95% CI: 0.272-2.323, p=0.67) which was not significant. Conclusion: preemptive Clonidine has superior effect compare to postoperative ketamin and pethidine in controlling postoperative shivering.

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Comparison of meperidine and nefopam for prevention of shivering during spinal anesthesia

Cited by 28 publications

References 24 publications

Comparison of effect of electroacupuncture and nefopam for prevention of postanesthetic shivering in patients undergoing urologic operation under spinal anesthesia

Comparison of effect of electroacupuncture and nefopam for prevention of postanesthetic shivering in patients undergoing urologic operation under spinal anesthesia

Dexmedetomidine versus Nefopam for the management of post-spinal anesthesia shivering: A randomized double-blind controlled study

Effect of Preemptive Clonidnine Versus Pethidine and Ketamine on Postoperative Shivering During Spinal Anesthesia

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