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Comparison of nalbuphine, ondansetron and placebo for the prevention of shivering after spinal anaesthesia for urgent caesarean delivery: a randomised double-blind controlled clinical trial.
Int J Obstet Anesth. 2020 05; 42:39-46.IJ

Abstract

BACKGROUND

Shivering is a common complication of caesarean delivery with neuraxial anaesthesia. The effective prevention and treatment of shivering, especially before delivery, is important and difficult. We tested the hypothesis that prophylactic nalbuphine and ondansetron can prevent post-spinal anaesthesia shivering in parturients undergoing urgent caesarean delivery.

METHODS

Sixty parturients scheduled for urgent caesarean delivery before spinal anaesthesia were selected and divided randomly into three groups. After peripheral venous catheterisation, parturients were given intravenous nalbuphine 0.08 mg/kg (group N), ondansetron 8 mg (group O), or normal saline (group C).

RESULTS

The incidence of shivering and of severe (grade ≥3) shivering was significantly lower in group N (15% and 15%, respectively) than in group C (80% and 65%) before delivery (P <0.001 and P=0.003); and significantly less shivering was observed in group N than in group C in the first 30 min after anaesthesia (P=0.001). Up to 60 min after anaesthesia, the incidence of grade ≥3 shivering remained lowest in group N (P=0.003). According to the data during the period from anaesthesia until delivery, the number needed-to-treat for nalbuphine was 1.54 (95%CI 1.13 to 2.41). No significant differences were found between groups O and N or groups O and C at any time. The incidence of dizziness in group N was significantly higher than that of groups O or C (P=0.009).

CONCLUSION

Nalbuphine 0.08 mg/kg can prevent post-spinal anaesthesia shivering in parturients undergoing urgent caesarean delivery but causes transient dizziness, while ondansetron 8 mg had no significant effect.

Authors+Show Affiliations

Department of Anaesthesiology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.Department of Anaesthesiology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China. Electronic address: Drhuangsq@163.com.Department of Anaesthesiology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.Department of Anaesthesiology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.Department of Anaesthesiology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31734098

Citation

Liu, J, et al. "Comparison of Nalbuphine, Ondansetron and Placebo for the Prevention of Shivering After Spinal Anaesthesia for Urgent Caesarean Delivery: a Randomised Double-blind Controlled Clinical Trial." International Journal of Obstetric Anesthesia, vol. 42, 2020, pp. 39-46.
Liu J, Huang S, Sun S, et al. Comparison of nalbuphine, ondansetron and placebo for the prevention of shivering after spinal anaesthesia for urgent caesarean delivery: a randomised double-blind controlled clinical trial. Int J Obstet Anesth. 2020;42:39-46.
Liu, J., Huang, S., Sun, S., Sun, X., & Wang, T. (2020). Comparison of nalbuphine, ondansetron and placebo for the prevention of shivering after spinal anaesthesia for urgent caesarean delivery: a randomised double-blind controlled clinical trial. International Journal of Obstetric Anesthesia, 42, 39-46. https://doi.org/10.1016/j.ijoa.2019.10.002
Liu J, et al. Comparison of Nalbuphine, Ondansetron and Placebo for the Prevention of Shivering After Spinal Anaesthesia for Urgent Caesarean Delivery: a Randomised Double-blind Controlled Clinical Trial. Int J Obstet Anesth. 2020;42:39-46. PubMed PMID: 31734098.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of nalbuphine, ondansetron and placebo for the prevention of shivering after spinal anaesthesia for urgent caesarean delivery: a randomised double-blind controlled clinical trial. AU - Liu,J, AU - Huang,S, AU - Sun,S, AU - Sun,X, AU - Wang,T, Y1 - 2019/10/24/ PY - 2019/03/22/received PY - 2019/09/28/revised PY - 2019/10/16/accepted PY - 2019/11/18/pubmed PY - 2019/11/18/medline PY - 2019/11/18/entrez KW - Caesarean delivery KW - Nalbuphine KW - Ondansetron KW - Shivering SP - 39 EP - 46 JF - International journal of obstetric anesthesia JO - Int J Obstet Anesth VL - 42 N2 - BACKGROUND: Shivering is a common complication of caesarean delivery with neuraxial anaesthesia. The effective prevention and treatment of shivering, especially before delivery, is important and difficult. We tested the hypothesis that prophylactic nalbuphine and ondansetron can prevent post-spinal anaesthesia shivering in parturients undergoing urgent caesarean delivery. METHODS: Sixty parturients scheduled for urgent caesarean delivery before spinal anaesthesia were selected and divided randomly into three groups. After peripheral venous catheterisation, parturients were given intravenous nalbuphine 0.08 mg/kg (group N), ondansetron 8 mg (group O), or normal saline (group C). RESULTS: The incidence of shivering and of severe (grade ≥3) shivering was significantly lower in group N (15% and 15%, respectively) than in group C (80% and 65%) before delivery (P <0.001 and P=0.003); and significantly less shivering was observed in group N than in group C in the first 30 min after anaesthesia (P=0.001). Up to 60 min after anaesthesia, the incidence of grade ≥3 shivering remained lowest in group N (P=0.003). According to the data during the period from anaesthesia until delivery, the number needed-to-treat for nalbuphine was 1.54 (95%CI 1.13 to 2.41). No significant differences were found between groups O and N or groups O and C at any time. The incidence of dizziness in group N was significantly higher than that of groups O or C (P=0.009). CONCLUSION: Nalbuphine 0.08 mg/kg can prevent post-spinal anaesthesia shivering in parturients undergoing urgent caesarean delivery but causes transient dizziness, while ondansetron 8 mg had no significant effect. SN - 1532-3374 UR - https://www.unboundmedicine.com/medline/citation/31734098/Comparison_of_nalbuphine_ondansetron_and_placebo_for_the_prevention_of_shivering_after_spinal_anaesthesia_for_urgent_caesarean_delivery:_a_randomised_double_blind_controlled_clinical_trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0959-289X(19)30557-6 DB - PRIME DP - Unbound Medicine ER -
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