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Prophylactic ondansetron does not prevent shivering or decrease shivering severity during cesarean delivery under combined spinal epidural anesthesia: a randomized trial.
Reg Anesth Pain Med. 2013 Jan-Feb; 38(1):39-43.RA

Abstract

OBJECTIVES

Cesarean delivery is commonly performed under regional anesthesia, which is often associated with maternal shivering. This can cause distress and interfere with monitoring. The study objective was to evaluate the antishivering efficacy of ondansetron, which reduces the incidence and severity of shivering in nonobstetric patients. We hypothesized that there would be a significant decrease in the incidence and/or severity of shivering in women who are given intravenous ondansetron 8 mg before combined spinal epidural (CSE) anesthesia, when compared with placebo.

METHODS

This was a randomized, double-blinded, parallel-group, placebo-controlled trial of 118 women scheduled for elective cesarean surgery. Women received either intravenous ondansetron 8 mg (n = 58) or saline (n = 60) before CSE anesthesia (intrathecal hyperbaric bupivacaine 0.5% 2.2-2.5 mL plus fentanyl 15 μg). The incidence and severity of shivering, measured on a validated 5-point scale, and other outcomes, such as nausea, pruritus, headache, or satisfaction, were assessed at 3 time points during the surgery and postoperative period.

RESULTS

The incidence of shivering at any time point did not differ significantly between groups: ondansetron 41% versus placebo 47% (P = 0.54). The incidence of severe shivering at any time was not significantly different: ondansetron 32% versus placebo 33% (P = 0.79). There were no significant differences between the groups for any secondary outcomes.

CONCLUSIONS

Intravenous ondansetron 8 mg before performing CSE anesthesia in women undergoing elective cesarean delivery does not decrease the incidence or severity of shivering.

Authors+Show Affiliations

Department of Anaesthesia and Pain Medicine, Fremantle Hospital, Western Australia, Australia. roger.browning@health.wa.gov.auNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

23104146

Citation

Browning, Roger M., et al. "Prophylactic Ondansetron Does Not Prevent Shivering or Decrease Shivering Severity During Cesarean Delivery Under Combined Spinal Epidural Anesthesia: a Randomized Trial." Regional Anesthesia and Pain Medicine, vol. 38, no. 1, 2013, pp. 39-43.
Browning RM, Fellingham WH, O'Loughlin EJ, et al. Prophylactic ondansetron does not prevent shivering or decrease shivering severity during cesarean delivery under combined spinal epidural anesthesia: a randomized trial. Reg Anesth Pain Med. 2013;38(1):39-43.
Browning, R. M., Fellingham, W. H., O'Loughlin, E. J., Brown, N. A., & Paech, M. J. (2013). Prophylactic ondansetron does not prevent shivering or decrease shivering severity during cesarean delivery under combined spinal epidural anesthesia: a randomized trial. Regional Anesthesia and Pain Medicine, 38(1), 39-43. https://doi.org/10.1097/AAP.0b013e31827049c6
Browning RM, et al. Prophylactic Ondansetron Does Not Prevent Shivering or Decrease Shivering Severity During Cesarean Delivery Under Combined Spinal Epidural Anesthesia: a Randomized Trial. Reg Anesth Pain Med. 2013 Jan-Feb;38(1):39-43. PubMed PMID: 23104146.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prophylactic ondansetron does not prevent shivering or decrease shivering severity during cesarean delivery under combined spinal epidural anesthesia: a randomized trial. AU - Browning,Roger M, AU - Fellingham,William H, AU - O'Loughlin,Edmond J, AU - Brown,Nicholas A, AU - Paech,Michael J, PY - 2012/10/30/entrez PY - 2012/10/30/pubmed PY - 2013/8/3/medline SP - 39 EP - 43 JF - Regional anesthesia and pain medicine JO - Reg Anesth Pain Med VL - 38 IS - 1 N2 - OBJECTIVES: Cesarean delivery is commonly performed under regional anesthesia, which is often associated with maternal shivering. This can cause distress and interfere with monitoring. The study objective was to evaluate the antishivering efficacy of ondansetron, which reduces the incidence and severity of shivering in nonobstetric patients. We hypothesized that there would be a significant decrease in the incidence and/or severity of shivering in women who are given intravenous ondansetron 8 mg before combined spinal epidural (CSE) anesthesia, when compared with placebo. METHODS: This was a randomized, double-blinded, parallel-group, placebo-controlled trial of 118 women scheduled for elective cesarean surgery. Women received either intravenous ondansetron 8 mg (n = 58) or saline (n = 60) before CSE anesthesia (intrathecal hyperbaric bupivacaine 0.5% 2.2-2.5 mL plus fentanyl 15 μg). The incidence and severity of shivering, measured on a validated 5-point scale, and other outcomes, such as nausea, pruritus, headache, or satisfaction, were assessed at 3 time points during the surgery and postoperative period. RESULTS: The incidence of shivering at any time point did not differ significantly between groups: ondansetron 41% versus placebo 47% (P = 0.54). The incidence of severe shivering at any time was not significantly different: ondansetron 32% versus placebo 33% (P = 0.79). There were no significant differences between the groups for any secondary outcomes. CONCLUSIONS: Intravenous ondansetron 8 mg before performing CSE anesthesia in women undergoing elective cesarean delivery does not decrease the incidence or severity of shivering. SN - 1532-8651 UR - https://www.unboundmedicine.com/medline/citation/23104146/Prophylactic_ondansetron_does_not_prevent_shivering_or_decrease_shivering_severity_during_cesarean_delivery_under_combined_spinal_epidural_anesthesia:_a_randomized_trial_ L2 - http://rapm.bmj.com/cgi/pmidlookup?view=long&pmid=23104146 DB - PRIME DP - Unbound Medicine ER -