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Prophylactic Low-Dose Ketamine to Prevent Post Anesthetic Shivering in Orthopedic Surgery: A Randomized-Controlled Study.
J Med Assoc Thai. 2016 Apr; 99(4):400-5.JM

Abstract

OBJECTIVE

Post anesthetic shivering is one of the most common anesthesia complications. We compared the efficacy of low-dose ketamine with normal saline in preventing post anesthetic shivering in orthopedic surgery.

MATERIAL AND METHOD

The present study was a prospective, randomized, double-blind, controlled clinical trial involving 183 ASA I-II patients, aged 18 to 65 years whom underwent orthopedic surgery with general anesthesia. The patients were randomly allocated to receive either ketamine 0.25 mg/kg (Group K, n = 91) or normal saline (Group P n = 92) 20 minutes before the completion of surgery. The tympanic temperature was measured before the induction of anesthesia, 30 minutes after induction, and before administration of the study drugs. An investigator, blinded to the patients' group affiliation, graded post anesthetic shivering using the Crossley and Mahajan scale. The primary outcome was to compare incidence of shivering on each group in recovery room. The secondary outcome was side effect of ketamine. Statistical analyses were performed using program R version 3.1.0. A p-value of < 0.05 was considered statistically significant.

RESULTS

The patient characteristics of the two groups were similar and the number of patients with observed shivering in both groups was not statistically significantly different (Group K = 13 (14.28%) and Group P = 15 (16.30%), p = 0.42). Furthermore, in both groups, no patient suffered from hallucination, and the other complications were not statistically different.

CONCLUSION

At the recovery room, no significant efficacy difference between low-dose ketamine (0.25 mg/kg) and placebo in the prevention of post operative shivering in patients who underwent orthopedic surgery was observed. Other factors such as preload warm intravenous fluid, using active warming during surgery and control of the room temperature may help prevent shivering.

Authors

No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

27396224

Citation

Petskul, Suttasinee, et al. "Prophylactic Low-Dose Ketamine to Prevent Post Anesthetic Shivering in Orthopedic Surgery: a Randomized-Controlled Study." Journal of the Medical Association of Thailand = Chotmaihet Thangphaet, vol. 99, no. 4, 2016, pp. 400-5.
Petskul S, Kitsiripant C, Rujirojindakul P, et al. Prophylactic Low-Dose Ketamine to Prevent Post Anesthetic Shivering in Orthopedic Surgery: A Randomized-Controlled Study. J Med Assoc Thai. 2016;99(4):400-5.
Petskul, S., Kitsiripant, C., Rujirojindakul, P., Chantarokorn, A., Jullabunyasit, A., & Thinchana, S. (2016). Prophylactic Low-Dose Ketamine to Prevent Post Anesthetic Shivering in Orthopedic Surgery: A Randomized-Controlled Study. Journal of the Medical Association of Thailand = Chotmaihet Thangphaet, 99(4), 400-5.
Petskul S, et al. Prophylactic Low-Dose Ketamine to Prevent Post Anesthetic Shivering in Orthopedic Surgery: a Randomized-Controlled Study. J Med Assoc Thai. 2016;99(4):400-5. PubMed PMID: 27396224.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prophylactic Low-Dose Ketamine to Prevent Post Anesthetic Shivering in Orthopedic Surgery: A Randomized-Controlled Study. AU - Petskul,Suttasinee, AU - Kitsiripant,Chanatthee, AU - Rujirojindakul,Panthila, AU - Chantarokorn,Amphan, AU - Jullabunyasit,Arporn, AU - Thinchana,Sarunyoo, PY - 2016/7/12/entrez PY - 2016/7/12/pubmed PY - 2016/8/6/medline SP - 400 EP - 5 JF - Journal of the Medical Association of Thailand = Chotmaihet thangphaet JO - J Med Assoc Thai VL - 99 IS - 4 N2 - OBJECTIVE: Post anesthetic shivering is one of the most common anesthesia complications. We compared the efficacy of low-dose ketamine with normal saline in preventing post anesthetic shivering in orthopedic surgery. MATERIAL AND METHOD: The present study was a prospective, randomized, double-blind, controlled clinical trial involving 183 ASA I-II patients, aged 18 to 65 years whom underwent orthopedic surgery with general anesthesia. The patients were randomly allocated to receive either ketamine 0.25 mg/kg (Group K, n = 91) or normal saline (Group P n = 92) 20 minutes before the completion of surgery. The tympanic temperature was measured before the induction of anesthesia, 30 minutes after induction, and before administration of the study drugs. An investigator, blinded to the patients' group affiliation, graded post anesthetic shivering using the Crossley and Mahajan scale. The primary outcome was to compare incidence of shivering on each group in recovery room. The secondary outcome was side effect of ketamine. Statistical analyses were performed using program R version 3.1.0. A p-value of < 0.05 was considered statistically significant. RESULTS: The patient characteristics of the two groups were similar and the number of patients with observed shivering in both groups was not statistically significantly different (Group K = 13 (14.28%) and Group P = 15 (16.30%), p = 0.42). Furthermore, in both groups, no patient suffered from hallucination, and the other complications were not statistically different. CONCLUSION: At the recovery room, no significant efficacy difference between low-dose ketamine (0.25 mg/kg) and placebo in the prevention of post operative shivering in patients who underwent orthopedic surgery was observed. Other factors such as preload warm intravenous fluid, using active warming during surgery and control of the room temperature may help prevent shivering. SN - 0125-2208 UR - https://www.unboundmedicine.com/medline/citation/27396224/Prophylactic_Low_Dose_Ketamine_to_Prevent_Post_Anesthetic_Shivering_in_Orthopedic_Surgery:_A_Randomized_Controlled_Study_ L2 - https://medlineplus.gov/aftersurgery.html DB - PRIME DP - Unbound Medicine ER -