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Prophylactic granisetron for post-spinal anesthesia shivering in cesarean section: A randomized controlled clinical study.
Acta Anaesthesiol Scand. 2019 03; 63(3):381-388.AA

Abstract

BACKGROUND

The serotonergic system is known to be involved in control of post-anesthetic shivering. Our hypothesis was that prophylactic granisetrone (serotonin antagonist) might reduce incidence of post-spinal anesthesia shivering in cesarean section.

METHODS

Parturient scheduled for elective cesarean delivery under spinal anesthesia were allocated to receive 0.9% saline (Group I, n = 71), 1 mg granisetron (Group II, n = 69), or 0.7 mg granisetron (Group III, n = 72) before the spinal block. Assessment parameters included; hemodynamics, tympanic membrane temperature, neonatal Apgar score, shivering score, patient satisfaction scores about shivering prophylaxis and adverse effects.

RESULTS

Clinically significant shivering was recorded in 55/71 patients (77.5%) in group I, 11/69 (15.9%) in group II and 21/72 (29.2%) in group III (P = 0.000). The intensity of shivering was significantly lower in patients who received granisetron 1 mg compared with granisetron 0.7 mg or saline (P = 0.000). Patients who received prophylactic granisetron 1 mg reported lower mean intraoperative arterial pressure and heart rate values and consumed higher doses of iv ephedrine compared with 0.7 mg granisetron or saline placebo (P < 0.05). Pruritus significantly decreased from (22.5%) in control group to (0%) in granisetron groups (P = 0.000). Nausea was reported in 8 vs 10 and four in group I, II and III, respectively (P < 0.03). Sixteen vs eight and six patients vomited in group I, II, and III, respectively (P < 0.03). Higher patient satisfaction scores were recorded in group II (9.83 ± 0.29, P < 0.03) and III (9.14 ± 1.04, P < 0.04), compared with control group (8.23 ± 1.14).

CONCLUSION

Prophylactic granisetron effectively reduced incidence and severity of perioperative shivering in a dose dependent manner, compared to placebo controls.

Authors+Show Affiliations

Anesthesia and Intensive Care Department, Faculty of Medicine, Assiut University, Assiut, Egypt.Anesthesia and Intensive Care Department, Faculty of Medicine, Assiut University, Assiut, Egypt.

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29424008

Citation

Abdel-Ghaffar, Hala S., and Seham M. Moeen. "Prophylactic Granisetron for Post-spinal Anesthesia Shivering in Cesarean Section: a Randomized Controlled Clinical Study." Acta Anaesthesiologica Scandinavica, vol. 63, no. 3, 2019, pp. 381-388.
Abdel-Ghaffar HS, Moeen SM. Prophylactic granisetron for post-spinal anesthesia shivering in cesarean section: A randomized controlled clinical study. Acta Anaesthesiol Scand. 2019;63(3):381-388.
Abdel-Ghaffar, H. S., & Moeen, S. M. (2019). Prophylactic granisetron for post-spinal anesthesia shivering in cesarean section: A randomized controlled clinical study. Acta Anaesthesiologica Scandinavica, 63(3), 381-388. https://doi.org/10.1111/aas.13084
Abdel-Ghaffar HS, Moeen SM. Prophylactic Granisetron for Post-spinal Anesthesia Shivering in Cesarean Section: a Randomized Controlled Clinical Study. Acta Anaesthesiol Scand. 2019;63(3):381-388. PubMed PMID: 29424008.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prophylactic granisetron for post-spinal anesthesia shivering in cesarean section: A randomized controlled clinical study. AU - Abdel-Ghaffar,Hala S, AU - Moeen,Seham M, Y1 - 2018/02/08/ PY - 2017/09/18/received PY - 2017/11/15/revised PY - 2018/01/10/accepted PY - 2018/2/10/pubmed PY - 2020/3/24/medline PY - 2018/2/10/entrez KW - cesarean section KW - granisetron KW - shivering KW - spinal anesthesia SP - 381 EP - 388 JF - Acta anaesthesiologica Scandinavica JO - Acta Anaesthesiol Scand VL - 63 IS - 3 N2 - BACKGROUND: The serotonergic system is known to be involved in control of post-anesthetic shivering. Our hypothesis was that prophylactic granisetrone (serotonin antagonist) might reduce incidence of post-spinal anesthesia shivering in cesarean section. METHODS: Parturient scheduled for elective cesarean delivery under spinal anesthesia were allocated to receive 0.9% saline (Group I, n = 71), 1 mg granisetron (Group II, n = 69), or 0.7 mg granisetron (Group III, n = 72) before the spinal block. Assessment parameters included; hemodynamics, tympanic membrane temperature, neonatal Apgar score, shivering score, patient satisfaction scores about shivering prophylaxis and adverse effects. RESULTS: Clinically significant shivering was recorded in 55/71 patients (77.5%) in group I, 11/69 (15.9%) in group II and 21/72 (29.2%) in group III (P = 0.000). The intensity of shivering was significantly lower in patients who received granisetron 1 mg compared with granisetron 0.7 mg or saline (P = 0.000). Patients who received prophylactic granisetron 1 mg reported lower mean intraoperative arterial pressure and heart rate values and consumed higher doses of iv ephedrine compared with 0.7 mg granisetron or saline placebo (P < 0.05). Pruritus significantly decreased from (22.5%) in control group to (0%) in granisetron groups (P = 0.000). Nausea was reported in 8 vs 10 and four in group I, II and III, respectively (P < 0.03). Sixteen vs eight and six patients vomited in group I, II, and III, respectively (P < 0.03). Higher patient satisfaction scores were recorded in group II (9.83 ± 0.29, P < 0.03) and III (9.14 ± 1.04, P < 0.04), compared with control group (8.23 ± 1.14). CONCLUSION: Prophylactic granisetron effectively reduced incidence and severity of perioperative shivering in a dose dependent manner, compared to placebo controls. SN - 1399-6576 UR - https://www.unboundmedicine.com/medline/citation/29424008/Prophylactic_granisetron_for_post_spinal_anesthesia_shivering_in_cesarean_section:_A_randomized_controlled_clinical_study_ L2 - https://doi.org/10.1111/aas.13084 DB - PRIME DP - Unbound Medicine ER -