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The Effect of Forced-Air Warmer, Ondansetron or their Combination on Shivering in Pregnant Women Coming for Elective Cesarean Section under Spinal Anesthesia: A Prospective, Randomized Controlled Comparative Study.
Anesth Essays Res. 2019 Jan-Mar; 13(1):19-24.AE

Abstract

Context

Perioperative shivering can occur in up to 85% of patients undergoing cesarean section under spinal anesthesia. It has many detrimental effects and disrupts early mother-child bonding. Therefore, it should ideally be prevented by either pharmacologic or nonpharmacological means.

Aims

The primary aim of this study was to evaluate the efficacy of intraoperative forced-air warming, ondansetron or their combination in preventing perioperative shivering in patients undergoing elective cesarean section under spinal anesthesia.

Settings and Design

A prospective randomized controlled comparative study done at the tertiary care center.

Subjects and Methods

A total of 120 patients undergoing elective cesarean section under spinal anesthesia were randomly assigned to three groups. Group O received ondansetron 4 mg intravenously (i.v.) after giving block with no forced air warming. Group W received forced-air warming intraoperatively. Group C received ondansetron 4 mg i.v. after giving block plus intraoperative forced-air warming. Core temperature (tympanic membrane) and the arm skin temperature were measured and shivering was graded simultaneously.

Statistical Analysis Used

Parametric data were analyzed using one-way ANOVA and Student's paired t-test where ever appropriate. Nonparametric data were analyzed using the Kruskal-Wallis and the Chi-square test. Values of P < 0.05 were considered statistically significant.

Results

Shivering incidence was higher in Group O and Group W being 17.5% and 20%, respectively, and least in Group C being 5%. The incidence of Grade ≥3 shivering requiring rescue drug was lower in Group C (2.5%) compared to that of the Groups W (5%) and O (10%) but was not statistically significant (P = 0.21).

Conclusions

Combined use of ondansetron and forced- air warmer was more effective in reducing the incidence of shivering in pregnant women during elective cesarean section than when used individually.

Authors+Show Affiliations

Department of Anaesthesiology, ESIC Medical College and Hospital, Hyderabad, Telangana, India.Department of Anaesthesiology, ESIC Medical College and Hospital, Hyderabad, Telangana, India.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31031474

Citation

Ram Kiran, K S., and Kalyani Surya Dhana Lakshmi Sangineni. "The Effect of Forced-Air Warmer, Ondansetron or Their Combination On Shivering in Pregnant Women Coming for Elective Cesarean Section Under Spinal Anesthesia: a Prospective, Randomized Controlled Comparative Study." Anesthesia, Essays and Researches, vol. 13, no. 1, 2019, pp. 19-24.
Ram Kiran KS, Sangineni KSDL. The Effect of Forced-Air Warmer, Ondansetron or their Combination on Shivering in Pregnant Women Coming for Elective Cesarean Section under Spinal Anesthesia: A Prospective, Randomized Controlled Comparative Study. Anesthesia, essays and researches. 2019;13(1):19-24.
Ram Kiran, K. S., & Sangineni, K. S. D. L. (2019). The Effect of Forced-Air Warmer, Ondansetron or their Combination on Shivering in Pregnant Women Coming for Elective Cesarean Section under Spinal Anesthesia: A Prospective, Randomized Controlled Comparative Study. Anesthesia, Essays and Researches, 13(1), 19-24. https://doi.org/10.4103/aer.AER_198_18
Ram Kiran KS, Sangineni KSDL. The Effect of Forced-Air Warmer, Ondansetron or Their Combination On Shivering in Pregnant Women Coming for Elective Cesarean Section Under Spinal Anesthesia: a Prospective, Randomized Controlled Comparative Study. Anesthesia, essays and researches. 2019 Jan-Mar;13(1):19-24. PubMed PMID: 31031474.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Effect of Forced-Air Warmer, Ondansetron or their Combination on Shivering in Pregnant Women Coming for Elective Cesarean Section under Spinal Anesthesia: A Prospective, Randomized Controlled Comparative Study. AU - Ram Kiran,K S, AU - Sangineni,Kalyani Surya Dhana Lakshmi, PY - 2019/4/30/entrez PY - 2019/4/30/pubmed PY - 2019/4/30/medline KW - Anesthesia KW - cesarean section KW - ondansetron KW - shivering KW - spinal SP - 19 EP - 24 JF - Anesthesia, essays and researches VL - 13 IS - 1 N2 - Context: Perioperative shivering can occur in up to 85% of patients undergoing cesarean section under spinal anesthesia. It has many detrimental effects and disrupts early mother-child bonding. Therefore, it should ideally be prevented by either pharmacologic or nonpharmacological means. Aims: The primary aim of this study was to evaluate the efficacy of intraoperative forced-air warming, ondansetron or their combination in preventing perioperative shivering in patients undergoing elective cesarean section under spinal anesthesia. Settings and Design: A prospective randomized controlled comparative study done at the tertiary care center. Subjects and Methods: A total of 120 patients undergoing elective cesarean section under spinal anesthesia were randomly assigned to three groups. Group O received ondansetron 4 mg intravenously (i.v.) after giving block with no forced air warming. Group W received forced-air warming intraoperatively. Group C received ondansetron 4 mg i.v. after giving block plus intraoperative forced-air warming. Core temperature (tympanic membrane) and the arm skin temperature were measured and shivering was graded simultaneously. Statistical Analysis Used: Parametric data were analyzed using one-way ANOVA and Student's paired t-test where ever appropriate. Nonparametric data were analyzed using the Kruskal-Wallis and the Chi-square test. Values of P < 0.05 were considered statistically significant. Results: Shivering incidence was higher in Group O and Group W being 17.5% and 20%, respectively, and least in Group C being 5%. The incidence of Grade ≥3 shivering requiring rescue drug was lower in Group C (2.5%) compared to that of the Groups W (5%) and O (10%) but was not statistically significant (P = 0.21). Conclusions: Combined use of ondansetron and forced- air warmer was more effective in reducing the incidence of shivering in pregnant women during elective cesarean section than when used individually. SN - 0259-1162 UR - https://www.unboundmedicine.com/medline/citation/31031474/The_Effect_of_Forced_Air_Warmer_Ondansetron_or_their_Combination_on_Shivering_in_Pregnant_Women_Coming_for_Elective_Cesarean_Section_under_Spinal_Anesthesia:_A_Prospective_Randomized_Controlled_Comparative_Study_ L2 - http://www.aeronline.org/article.asp?issn=0259-1162;year=2019;volume=13;issue=1;spage=19;epage=24;aulast=Ram DB - PRIME DP - Unbound Medicine ER -
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