Nefopam and Meperidine Are Infra-Additive on the Shivering Threshold in Humans

Alfonsi, Pascal; Passard, Andréa; Guignard, B.; Chauvin, M.; Sessler, Daniel I.

doi:10.1213/ane.0000000000000193

Cited by 8 publications

(5 citation statements)

References 48 publications

(32 reference statements)

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“…Another limitation is that we did not check peripheral skin temperature. While nefopam does not affect vasoconstriction thresholds it does reduce shivering threshold [89], and, EA directly induces peripheral vasoconstriction [1213]. In our study, the core temperatures in the nefopam and EA groups were not significantly different.…”

Section: Discussioncontrasting

confidence: 47%

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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: Discussioncontrasting

confidence: 47%

“…As a result, it is effective in the prevention and treatment of shivering. Unlike other drugs [89], nefopam maintains hemodynamic stability [1011], but does not induce respiratory depression or sedation.…”

Section: Introductionmentioning

confidence: 99%

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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“…Sedatives and hypnotics including midazolam, lorazepam, diazepam, dexmetomidine, propofol, and buspirone have shiver threshold reductions ranging from 0.5 to 2.4°C when used alone and many are effective in synergistic combinations [82][83][84][85][86][87][88][89][90][91][92]. Analgesic agents such as nefopam, alfentanil, fentanyl, and meperidine have also been evaluated both as monotherapy and in combinations [93][94][95][96][97][98][99]. Meperidine appears to be the most beneficial of all opioids with reported reductions in shiver thresholds between 1.2 and 2.2°C [98,99].…”

Section: Recommendationsmentioning

confidence: 99%

The Implementation of Targeted Temperature Management: An Evidence-Based Guideline from the Neurocritical Care Society

et al. 2017

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“…However, the mechanism of analgesic action is not understood, but is similar to that of monoamine reuptake inhibitors (serotonin, norepinephrine, dopamine and noradrenaline) and is used not only as an analgesic drug for nociceptive pain, but also as a treatment for the prevention of postoperative thrill and hiccups. In some reports, Nefopam blocks voltage-sensitive sodium channels and modulates glutamatergic transmission [ 135 ] as well as being effective in the prevention and treatment of shivering [ 136 , 137 ].…”

Section: Phytochemical Studies Of the Argan Fruitsmentioning

confidence: 99%

Ethnobotanic, Ethnopharmacologic Aspects and New Phytochemical Insights into Moroccan Argan Fruits

Khallouki

Eddouks²,

Akdad³

et al. 2017

IJMS

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This review summarizes available data on argan fruit botany, geographical distribution, traditional uses, environmental interest, socioeconomic role, phytochemistry, as well as health beneficial effects and examination of future prospects. In particular, ethnomedical uses of argan fruits are carried out throughout Morocco where it has been used against various diseases. Different classes of bioactive compounds have been characterized including essential oils, fatty acids, triacylglycerols, flavonoids and their newly reported acylglycosyl derivatives, monophenols, phenolic acids, cinnamic acids, saponins, triterpenes, phytosterols, ubiquinone, melatonin, new aminophenols along with vitamin E among other secondary metabolites. The latter have already shown a wide spectrum of in vitro, and ex vivo biologicalactivities including antioxidant, anti-inflammatory, anti-diabetic, antihypertensive, anti-hypercholesterolemia, analgesic, antimicrobial, molluscicidal anti-nociceptive and anticancer potential. Argan flesh (pulp) contains a broad spectrum of polyphenolic compounds which may have utility for incorporation into nutraceuticals and cosmeceuticals relevant to the food, cosmetic and health industries. Further research is recommended, especially on the health beneficial effects of the aminophenols.

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Nefopam and Meperidine Are Infra-Additive on the Shivering Threshold in Humans

Abstract: The combination of nefopam and meperidine should be avoided for induction of therapeutic hypothermia. Better options would be combinations of drugs that are at least additive or even synergistic.

Cited by 8 publications

References 48 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

The Implementation of Targeted Temperature Management: An Evidence-Based Guideline from the Neurocritical Care Society

Ethnobotanic, Ethnopharmacologic Aspects and New Phytochemical Insights into Moroccan Argan Fruits

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