Tags

Type your tag names separated by a space and hit enter

Comparison of weight-adjusted dose versus fixed dose ondansetron in preventing shivering following spinal anaesthesia for caesarean deliveries.
Afr Health Sci. 2019 Sep; 19(3):2740-2751.AH

Abstract

Background

Spinal anaesthesia is an effective regional anaesthesia technique, which is preferred in almost 86% of caesarean sections in the United States and United Kingdom. Eighty percent of caesarean sections done at the Aga Khan University hospital are under spinal anaesthesia. Shivering is a common complication of spinal anaesthesia, it occurs in 40%-64% of patients after neuraxial anaesthesia. Shivering may cause maternal and fetal hypoxemia, maternal discomfort and a problem to the anaesthesiologists when it comes to monitoring the patient during caesarean sections. Ondansetron a 5-HT3 receptor antagonist is effective in treatment and prevention of post-spinal anesthesia shivering. In published studies, use of a fixed dose in patients with different weights, masked the dose effect ondansetron in preventing shivering, such that not adjusting the dose according to the weight of patients' resulted in a higher occurrence of shivering. No study has compared different doses of ondansetron in preventing shivering in parturient women who have had spinal anaesthesia for caesarean section.

Objectives

To determine if a weight-adjusted dose is better than a fixed dose of ondansetron in preventing shivering following spinal anesthesia for caesarean delivery.

Method

This was a randomized, double-blinded controlled trial of 124 women scheduled for elective caesarean surgery. The women were randomized into two equal groups. The intervention group received intravenous ondansetron weight adjusted dosing at 0.1mg/kg and the control group received a fixed dose of 4mg before spinal anesthesia. The occurrence and severity of shivering and other outcomes, such as headache, pruritus were assessed and recorded during the surgery and post-operative period.

Results

A total of 124 patients were included in the study. Social demographic data and baseline vital signs did not differ significantly between the groups. Shivering was observed in 14 patients (22.6%) in the control group that received 4mg ondansetron and 7 patients (11.3%) in the intervention group that had 0.1mg/kg of ondansetron, but there was no statistical difference between the groups (p- value 0.090). The severity of shivering was greater in the control group compared to intervention group where patients who developed grade two shivering were 8.1% to 0% respectively. (P value 0.047). There was no difference in the occurrence of pruritus between the two groups. No patient required treatment for very severe shivering.

Conclusion

This study, found that ondansetron weight adjusted dose at 0.1mg/kg, reduced the severity of shivering when compared to a fixed dose ondansetron at 4mg.

Authors+Show Affiliations

Department of Anaesthesia, Aga Khan University, East Africa.Department of Anaesthesia, Aga Khan University, East Africa.Department of Anaesthesia, Aga Khan University, East Africa.Department of Anaesthesia, Aga Khan University, East Africa.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32127847

Citation

Gicheru, Moses, et al. "Comparison of Weight-adjusted Dose Versus Fixed Dose Ondansetron in Preventing Shivering Following Spinal Anaesthesia for Caesarean Deliveries." African Health Sciences, vol. 19, no. 3, 2019, pp. 2740-2751.
Gicheru M, Mung'ayi V, Mir S, et al. Comparison of weight-adjusted dose versus fixed dose ondansetron in preventing shivering following spinal anaesthesia for caesarean deliveries. Afr Health Sci. 2019;19(3):2740-2751.
Gicheru, M., Mung'ayi, V., Mir, S., & Kabugi, J. (2019). Comparison of weight-adjusted dose versus fixed dose ondansetron in preventing shivering following spinal anaesthesia for caesarean deliveries. African Health Sciences, 19(3), 2740-2751. https://doi.org/10.4314/ahs.v19i3.50
Gicheru M, et al. Comparison of Weight-adjusted Dose Versus Fixed Dose Ondansetron in Preventing Shivering Following Spinal Anaesthesia for Caesarean Deliveries. Afr Health Sci. 2019;19(3):2740-2751. PubMed PMID: 32127847.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of weight-adjusted dose versus fixed dose ondansetron in preventing shivering following spinal anaesthesia for caesarean deliveries. AU - Gicheru,Moses, AU - Mung'ayi,Vitalis, AU - Mir,Samina, AU - Kabugi,Jimmie, PY - 2020/3/5/entrez PY - 2020/3/5/pubmed PY - 2020/3/5/medline KW - Weight-adjusted dose KW - caesarean deliveries KW - fixed dose ondansetron KW - shivering KW - spinal anaesthesia SP - 2740 EP - 2751 JF - African health sciences JO - Afr Health Sci VL - 19 IS - 3 N2 - Background: Spinal anaesthesia is an effective regional anaesthesia technique, which is preferred in almost 86% of caesarean sections in the United States and United Kingdom. Eighty percent of caesarean sections done at the Aga Khan University hospital are under spinal anaesthesia. Shivering is a common complication of spinal anaesthesia, it occurs in 40%-64% of patients after neuraxial anaesthesia. Shivering may cause maternal and fetal hypoxemia, maternal discomfort and a problem to the anaesthesiologists when it comes to monitoring the patient during caesarean sections. Ondansetron a 5-HT3 receptor antagonist is effective in treatment and prevention of post-spinal anesthesia shivering. In published studies, use of a fixed dose in patients with different weights, masked the dose effect ondansetron in preventing shivering, such that not adjusting the dose according to the weight of patients' resulted in a higher occurrence of shivering. No study has compared different doses of ondansetron in preventing shivering in parturient women who have had spinal anaesthesia for caesarean section. Objectives: To determine if a weight-adjusted dose is better than a fixed dose of ondansetron in preventing shivering following spinal anesthesia for caesarean delivery. Method: This was a randomized, double-blinded controlled trial of 124 women scheduled for elective caesarean surgery. The women were randomized into two equal groups. The intervention group received intravenous ondansetron weight adjusted dosing at 0.1mg/kg and the control group received a fixed dose of 4mg before spinal anesthesia. The occurrence and severity of shivering and other outcomes, such as headache, pruritus were assessed and recorded during the surgery and post-operative period. Results: A total of 124 patients were included in the study. Social demographic data and baseline vital signs did not differ significantly between the groups. Shivering was observed in 14 patients (22.6%) in the control group that received 4mg ondansetron and 7 patients (11.3%) in the intervention group that had 0.1mg/kg of ondansetron, but there was no statistical difference between the groups (p- value 0.090). The severity of shivering was greater in the control group compared to intervention group where patients who developed grade two shivering were 8.1% to 0% respectively. (P value 0.047). There was no difference in the occurrence of pruritus between the two groups. No patient required treatment for very severe shivering. Conclusion: This study, found that ondansetron weight adjusted dose at 0.1mg/kg, reduced the severity of shivering when compared to a fixed dose ondansetron at 4mg. SN - 1729-0503 UR - https://www.unboundmedicine.com/medline/citation/32127847/Comparison_of_weight_adjusted_dose_versus_fixed_dose_ondansetron_in_preventing_shivering_following_spinal_anaesthesia_for_caesarean_deliveries_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/32127847/ DB - PRIME DP - Unbound Medicine ER -
Try the Free App:
Prime PubMed app for iOS iPhone iPad
Prime PubMed app for Android
Prime PubMed is provided
free to individuals by:
Unbound Medicine.