The Effect of Epidural Sufentanil on Shivering and Body Temperature in the Parturient

Sevarino, Ferne B.; Johnson, Mark D.; Lema, M. J.; Datta, Sanjay; Ostheimer, Gerard W.; Naulty, J. S.

doi:10.1213/00000539-198904000-00021

Cited by 44 publications

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“…Alfonsi et al [ 31 ] found that at a given dose, sufentanil inhibited shivering 2800 times better than meperidine, showing that sufentanil can significantly reduce shivering threshold. Sevarino et al [ 32 ] confirmed that high-dose sufentanil could reduce the occurrence of shivering. Johnson et al [ 33 ] also reported that a parturient’s shivering was stopped after epidural injection of 100 ug sufentanil.…”

Section: Discussionmentioning

confidence: 99%

Intrathecal Sufentanil Does Not Reduce Shivering During Neuraxial Anesthesia: A Meta-Analysis

et al. 2016

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BackgroundWe performed this meta-analysis to evaluate the efficacy of intrathecal sufentanil in preventing shivering during neuraxial anesthesia.Material/MethodsWe searched the Cochrane Library, PubMed, and Embase for all randomized controlled trials (RCT) on use of intrathecal sufentanil for preventing shivering during neuraxial anesthesia. References of retrieved articles were also screened. The quality of the studies was evaluated by the method recommended by the Cochrane Collaboration. Meta-analysis was conducted using the Cochrane Collaboration’s RevMan 5.3 software. The primary outcome was incidence and severity of shivering, and the secondary outcomes were drug-related complications of pruritus, nausea, vomiting, hypotension, and bradycardia.ResultsEight original RCTs investigating a total of 1032 patients, of whom 599 received sufentanil and 473 received placebo, met the inclusion criteria. Compared to the placebo group, sufentanil did not reduce incidence of shivering (OR, 0.60; 95% CI, 0.35 to 1.01; P=0.06), but it increased the incidence of pruritus (OR, 12.52; 95% CI, 5.07 to 30.91; P<0.00001). Compared to the placebo group, sufentanil did not increase the incidence of nausea (OR, 0.69; 95% CI, 0.41 to 1.16; P=0.16), hypotension (OR, 0.93; 95% CI, 0.62 to 1.41; P=0.74), or bradycardia (OR, 0.86; 95% CI, 0.41 to 1.82; P=0.70). In addition, sufentanil reduced the incidence of vomiting during neuraxial anesthesia (OR, 0.45; 95% CI, 0.22 to 0.92; P=0.03).ConclusionsNeither epidural nor subarachnoid intrathecal sufentanil reduced shivering during neuraxial anesthesia, but it did increase the incidence of pruritus.

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Section: Discussionmentioning

confidence: 99%

Intrathecal Sufentanil Does Not Reduce Shivering During Neuraxial Anesthesia: A Meta-Analysis

et al. 2016

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“…14 Clinically significant hypothermia has been reported in humans after epidural administration of high-dose sufentanil. 15 Opioids are known to be involved in thermoregulation and the determination of the temperature "set point". 3 The temperature control is mediated in part by delta opioid receptors in the hypothalamus.…”

Section: Discussionmentioning

confidence: 99%

Hypothermia and excessive sweating following intrathecal morphine in a parturient undergoing cesarean delivery

Sayyid

Jabbour

Baraka

2003

Regional Anesthesia and Pain Medicine

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“…It may be, however, that by suppressing shivering we may unmask a group of patients whose core temperature is reduced with extensive epidural blockade, as suggested by the evidence from the Harvard group. 6 More recently it has been postulated that shivering occurring during epidural anaesthesia may represent a motor disorder due to 'loss of motor control secondary to altered sensory input',1O such as may be unmasked in the patient with subclinical Parkinson's disease. The action of opioids on spinal cord receptors in this context is unclear, although results from animal studies suggest the importance of opioid receptors in the shivering response to cold environment.…”

Section: Discussionmentioning

confidence: 99%

The Influence of Epidural Pethidine on Shivering during Lower Segment Caesarean Section under Epidural Anaesthesia

Sutherland

Seaton

Lowry

1991

Anaesth Intensive Care

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A prospective study of 94 patients undergoing elective lower segment caesarean section under epidural anaesthesia was performed in order to determine the incidence of shivering and the influence of epidural pethidine. Epidural anaesthesia was established with bupivacaine 0.5% with adrenaline, with or without additional lignocaine 2% with adrenaline, to total 20-25 ml. With the injection of epidural local anaesthesia an extra 5 ml of solution was administered into the epidural space-pethidine 25 mg preservative-free, in normal saline, or normal saline alone. Patient, administering anaesthetist and observer were blinded to the nature of the test substance. Shivering was assessed by an independent observer and subsequently rated by the patient. Other side-effects also recorded were nausea, vomiting, pruritis and drowsiness. The incidence of shivering was 36% in the control (saline) group and 11% in the pethidine group. The difference was highly significant (P < 0.01). There was no significant difference in the incidence of maternal nausea, vomiting, drowsiness or pruritis, or neonatal Apgar scores. Cord blood samples were assayed for pethidine, revealing low or absent pethidine concentrations.

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The Effect of Epidural Sufentanil on Shivering and Body Temperature in the Parturient

Cited by 44 publications

References 0 publications

Intrathecal Sufentanil Does Not Reduce Shivering During Neuraxial Anesthesia: A Meta-Analysis

Intrathecal Sufentanil Does Not Reduce Shivering During Neuraxial Anesthesia: A Meta-Analysis

Hypothermia and excessive sweating following intrathecal morphine in a parturient undergoing cesarean delivery

The Influence of Epidural Pethidine on Shivering during Lower Segment Caesarean Section under Epidural Anaesthesia

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