In Spinal Anaesthesia for Cesarean Section the Temperature of Bupivacaine Affects the Onset of Shivering but Not the Incidence: A Randomized Control Trial
Introduction: Postoperative shivering is a frequent event after cesarean section under spinal anaesthesia. Shivering is uncomfortable for the patient and may interfere with monitoring. The exact aetiology of shivering is unknown and therefore has no definite treatment. Aim: The temperature of i...
Main Authors: | , , , |
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Format: | Article |
Language: | English |
Published: |
JCDR Research and Publications Private Limited
2016-01-01
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Series: | Journal of Clinical and Diagnostic Research |
Subjects: | |
Online Access: | https://jcdr.net/articles/PDF/7118/15883_CE(RA1)_F(T)_PF1(BMAK)_PFA(AK)_PF2(PAG).pdf |
Summary: | Introduction: Postoperative shivering is a frequent event
after cesarean section under spinal anaesthesia. Shivering is
uncomfortable for the patient and may interfere with monitoring.
The exact aetiology of shivering is unknown and therefore has no
definite treatment.
Aim: The temperature of injectate affects the spread of drug and
so its effect. Therefore the aim of this study was to compare the
effect of temperature of bupivacaine on post-spinal shivering in
cesarean section.
Materials and Methods: In this prospective, randomized,
controlled, double-blind clinical trial 105 ASA-I/II pregnant women
scheduled for caesarean section under spinal anaesthesia were
selected and randomized into three groups of 35 each. In all
pregnant women spinal anaesthesia was achieved with 2.2 ml
of 0.5% hyperbaric bupivacaine given either at L3-L4 or L4-L5
interspace. The temperature of bupivacaine was adjusted to
4°C (group T4
), 22°C (group T22) and 37°C (group T37). Shivering
characteristic, onset and incidence was noted. All three groups
were compared using analysis of variance (ANOVA), adverse
effects was compared using chi-square test and Kruskal-Wallis
H-test. The p-value < 0.05-considered as significant and p-value
<0.01-considered highly significant
Results: There were no differences between the groups regarding
age, weight, height, amount of fluid used and blood loss. The
incidence of shivering was 51.42%, 51.42% and 45.71% in
group T4
, group T22 and group T37 respectively, this difference in
the incidence was statistically not significant (p=0.858). However,
the onset of shivering was earliest (9.87±1.82 min) in group T4 as
compared to 14.27±3.02 min and 12.16±2.89 min in group T22
and group T37 respectively and this difference in the onset was
highly significant (p= 0.0001)
Conclusion: In spinal anaesthesia for cesarean section, the
temperature of bupivacaine does not influence the overall incidence
of post spinal shivering; however cold bupivacaine can provoke
early onset of shivering. |
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ISSN: | 2249-782X 0973-709X |