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Postoperative Management of Shivering: A Comparison of Pethidine vs. Ketamine.

ABSTRACT: BACKGROUND: One of the unpleasant side effects of general anesthesia is shivering in the process of recovery. It is an involuntary oscillatory mechanical movement that can be classified as clonic movements. These movements can affect one or several groups of skeletal muscles beginning from 5 to 30 minutes after the discontinuation of anesthesia. OBJECTIVES: We aimed to study ketamine's effect on shivering after operation compared to pethidine as a way for treatment of postoperative shivering. PATIENTS AND METHODS: In this study, 60 patients who underwent ENT surgery with general anesthesia and had shivering during recovery were randomly divided into two groups of 30 patients each receiving ketamine (0.2 mg/kg IV) and pethidine (0.5 mg/kg). RESULTS: There was no statistically significant difference between the shivering intensity in both groups. Only regarding the shivering in the first minute after entering the recovery room, there was an obvious difference between ketamine and pethidine groups which was again not statistically significant (P = 0.07). CONCLUSIONS: The results of this study showed that ketamine and pethidine are both equally effective in the reduction of postoperative shivering.

SUBMITTER: Eydi M

PROVIDER: S-EPMC4013503 | biostudies-other | 2014 May

REPOSITORIES: biostudies-other

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Postoperative Management of Shivering: A Comparison of Pethidine vs. Ketamine.

Eydi Mahmood M Golzari Samad Ej SE Aghamohammadi Davood D Kolahdouzan Khosro K Safari Saeid S Ostadi Zohreh Z

Anesthesiology and pain medicine 20140314 2

<h4>Background</h4>One of the unpleasant side effects of general anesthesia is shivering in the process of recovery. It is an involuntary oscillatory mechanical movement that can be classified as clonic movements. These movements can affect one or several groups of skeletal muscles beginning from 5 to 30 minutes after the discontinuation of anesthesia.<h4>Objectives</h4>We aimed to study ketamine's effect on shivering after operation compared to pethidine as a way for treatment of postoperative ...[more]

PMID: 24829883

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Project description:OBJECTIVE:A simple but reliable and safe anaesthetic procedure is required for surgical interventions in small rodents. Combined ketamine and xylazine injections are often used in rats for less invasive surgery, possibly with spontaneous breathing and without airway management. However, there are important pitfalls to be avoided by special precautions and monitoring, as shown subsequently. STUDY DESIGN:Observational study. ANIMALS:Twenty-four anaesthetic procedures for bile duct ligation, sham operation or carotid artery dilatation in 20 male Sprague-Dawley rats, preoperatively weighing between 440 and 550 g. METHODS:Intolerable high mortality rates occurred in the first 7 postoperative days while establishing a new experimental model in rats using ketamine-xylazine anaesthesia. Rats were spontaneously breathing ambient air during the first 12 surgeries without airway management. An observed high mortality rate in these animals led to a change in the trial protocol: the insufflation of 2 litres of oxygen per minute via nose cone during the following 12 rat surgeries. Retrospective comparison of the outcome (without oxygen vs. with oxygen insufflation) was conducted. RESULTS:The perioperative mortality rate could be significantly reduced from 58% (7/12) to 17% (2/12) (p = 0.036) by oxygen insufflation via nose cone. Significantly different levels of intraoperative oxygen saturation (SpO2; 89 ± 4% [without oxygen] vs. 97 ± 0.5% [with oxygen], p < 0.0001), but no significant differences in heart rate (HR; 267 ± 7 beats minute-1 [bpm] [without oxygen] vs. 266 ± 6 bpm [with oxygen], p = 0.955) were observed. CONCLUSIONS AND CLINICAL RELEVANCE:In summary, rats under ketamine-xylazine anaesthesia are susceptible to hypoxia. This may lead to increased delayed mortality related to hypoxia induced lung failure. Apparently, this is an underestimated problem. We highly recommend using additional oxygen insufflation in spontaneously breathing rats under ketamine-xylazine anaesthesia with basic monitoring such as measurement of oxygen saturation.

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Postoperative Management of Shivering: A Comparison of Pethidine vs. Ketamine.

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Postoperative Management of Shivering: A Comparison of Pethidine vs. Ketamine.

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