تاثير اندانسترون و پتيدين در پيشگيري ار لرز بعد از عمل به دنبال بيهوشي عمومي

Comparison the Effect of Ondansetron and Meperidine in the Prevention of Postoperative Shivering After General Anesthesia

Background: Postoperative shivering is one of the common problems after general anesthesia and may lead to multiple complications such as latent recovery from anesthesia and heart problems. Different drugs and methods have been used in prevention and treatment of the postoperative shivering. The aim of this study was to examine the effects of pre -anesthesia administration of ondansetron and meperidine on the postoperative shivering incidence in compare to the effect of placebo. Materials and Methods: In this randomized placebo-controlled double blind clinical trial, 90 patients who were scheduled for elective gynecologic operations, randomly assigned to one of three groups. In first group, 4 mg ondansetron, in second group 0.4 mg/kg meperidine and in third group (control group) 2cc normal saline were administerea immediately before the induction of anesthesia. In all patients anesthesia induced equivalently. Core temperature, dermal temperature, systolic and diastolic blood pressure and heart rate of patients were measured before the induction of anesthesia and during that and in the recovery room. Also incidence of postoperative shivering, nausea and vomiting was monitored and recorded by the nurse who was responsible for the recovery section. Results: Postoperative shivering was observed in 13.3% of patients in ondansetron group and 20% of meperidine group which were significantly less than the incidence of postoperative shivering in control group (50%) (p< 0.05). The reduction of core and dermal temperature during the anesthesia and recovery was seen in all three groups of study and did not significantly differ from each other (p>0.05). The changes of systolic and diastolic blood pressure and heart rate did not show any significant difference in three groups (p>0.05). The incidence of nausea was similar among three groups of study 10% (3 patients in each group), however vomiting was found in 6.7% of meperidine and 3.3 % of control group. None of the patients of ondansetron group had post operative vomiting. Conclusion: Administration of 4mg ondansetron before the induction of anesthesia have significant effect on the reduction of postoperative shivering incidence. As a result of hemodynamic stability and reduction of nausea and vomiting, ondansetron can be used in outpatients operation particularly in patients with cardiovascular problems.