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Prophylactic ketamine to prevent shivering in parturients undergoing Cesarean delivery during spinal anesthesia.
J Clin Anesth. 2013 Jun; 25(4):275-80.JC

Abstract

STUDY OBJECTIVE

To compare the efficacy and safety of ketamine 0.25 mg/kg with ketamine 0.5 mg/kg to prevent shivering in patients undergoing Cesarean delivery.

DESIGN

Prospective, randomized, double-blinded, placebo-controlled study.

SETTING

Operating rooms and postoperative recovery rooms.

PATIENTS

120 ASA physical status 1 and 2 pregnant women scheduled for Cesarean delivery during spinal anesthesia.

MEASUREMENTS

Patient characteristics, anesthetic and surgical details, Apgar scores at 1 and 5 minutes, and side effects of the study drugs were recorded. Heart rate, mean arterial pressure, oxygen saturation via pulse oximetry, tympanic temperature, severity of shivering, and degree of sedation were recorded before intrathecal injection and thereafter every 5 minutes. Patients were randomized to three groups: saline (Group C, n=30), intravenous (IV) ketamine 0.25 mg/kg (Group K-0.25, n=30), or IV ketamine 0.5 mg/kg (Group K-0.5, n=30). Grade 3 or 4 shivering was treated with IV meperidine 25 mg and the prophylaxis was regarded as ineffective.

MAIN RESULTS

The number of shivering patients was significantly less in Group K-0.25 and in Group K-0.5 than in Group C (P = 0.001, P = 0.001, respectively). The tympanic temperature values of Group C were lower at all times of the study than in either ketamine group. Median sedation scores of Group K-0.5 were significantly higher than in Group K-0.25 or Group C at 10, 20, 30, and 40 minutes after spinal anesthesia.

CONCLUSIONS

Prophylactic IV ketamine 0.25 mg/kg was as effective as IV ketamine 0.5 mg/kg in preventing shivering in patients undergoing Cesarean section during spinal anesthesia.

Authors+Show Affiliations

Department of Anesthesiology and Reanimation, Kirikkale University, School of Medicine, Kirikkale, Turkey. arzuhct@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

23664773

Citation

Kose, E A., et al. "Prophylactic Ketamine to Prevent Shivering in Parturients Undergoing Cesarean Delivery During Spinal Anesthesia." Journal of Clinical Anesthesia, vol. 25, no. 4, 2013, pp. 275-80.
Kose EA, Honca M, Dal D, et al. Prophylactic ketamine to prevent shivering in parturients undergoing Cesarean delivery during spinal anesthesia. J Clin Anesth. 2013;25(4):275-80.
Kose, E. A., Honca, M., Dal, D., Akinci, S. B., & Aypar, U. (2013). Prophylactic ketamine to prevent shivering in parturients undergoing Cesarean delivery during spinal anesthesia. Journal of Clinical Anesthesia, 25(4), 275-80. https://doi.org/10.1016/j.jclinane.2012.11.014
Kose EA, et al. Prophylactic Ketamine to Prevent Shivering in Parturients Undergoing Cesarean Delivery During Spinal Anesthesia. J Clin Anesth. 2013;25(4):275-80. PubMed PMID: 23664773.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prophylactic ketamine to prevent shivering in parturients undergoing Cesarean delivery during spinal anesthesia. AU - Kose,E A, AU - Honca,M, AU - Dal,D, AU - Akinci,S B, AU - Aypar,U, Y1 - 2013/05/07/ PY - 2012/07/27/received PY - 2012/11/12/revised PY - 2012/11/21/accepted PY - 2013/5/14/entrez PY - 2013/5/15/pubmed PY - 2014/6/19/medline KW - Anesthesia, obstetric KW - Cesarean section KW - Ketamine KW - Shivering, spinal anesthesia SP - 275 EP - 80 JF - Journal of clinical anesthesia JO - J Clin Anesth VL - 25 IS - 4 N2 - STUDY OBJECTIVE: To compare the efficacy and safety of ketamine 0.25 mg/kg with ketamine 0.5 mg/kg to prevent shivering in patients undergoing Cesarean delivery. DESIGN: Prospective, randomized, double-blinded, placebo-controlled study. SETTING: Operating rooms and postoperative recovery rooms. PATIENTS: 120 ASA physical status 1 and 2 pregnant women scheduled for Cesarean delivery during spinal anesthesia. MEASUREMENTS: Patient characteristics, anesthetic and surgical details, Apgar scores at 1 and 5 minutes, and side effects of the study drugs were recorded. Heart rate, mean arterial pressure, oxygen saturation via pulse oximetry, tympanic temperature, severity of shivering, and degree of sedation were recorded before intrathecal injection and thereafter every 5 minutes. Patients were randomized to three groups: saline (Group C, n=30), intravenous (IV) ketamine 0.25 mg/kg (Group K-0.25, n=30), or IV ketamine 0.5 mg/kg (Group K-0.5, n=30). Grade 3 or 4 shivering was treated with IV meperidine 25 mg and the prophylaxis was regarded as ineffective. MAIN RESULTS: The number of shivering patients was significantly less in Group K-0.25 and in Group K-0.5 than in Group C (P = 0.001, P = 0.001, respectively). The tympanic temperature values of Group C were lower at all times of the study than in either ketamine group. Median sedation scores of Group K-0.5 were significantly higher than in Group K-0.25 or Group C at 10, 20, 30, and 40 minutes after spinal anesthesia. CONCLUSIONS: Prophylactic IV ketamine 0.25 mg/kg was as effective as IV ketamine 0.5 mg/kg in preventing shivering in patients undergoing Cesarean section during spinal anesthesia. SN - 1873-4529 UR - https://www.unboundmedicine.com/medline/citation/23664773/Prophylactic_ketamine_to_prevent_shivering_in_parturients_undergoing_Cesarean_delivery_during_spinal_anesthesia_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0952-8180(13)00127-X DB - PRIME DP - Unbound Medicine ER -