Comparing Of Different Anti-shivering Drugs' Effects And Their Affect On Anesthesia Recovery

ObjectiveTo investigate how different anti-shivering drugs affect on anesthesia recovery, including their anti-shivering effect, and its impact on postoperative nausea and vomiting, pain control and sedation during recovery course. The study intends to develop individualized treatment strategies for postoperative shivering. Doxapram and pethidine were compared in this part of study.MethodsTwenty-four patients who shivered during recovery from general anesthesia were allocated randomly to receive normal saline, doxapram 1.0mg/kg or pethidine 0.5 mg/kg.The investigator who gave the i.v. injection was unaware of the treatment received by the patient. Shivering grade,sedation score,tympanic temperature,oxygen saturation, heart rate and arterial pressure were recorded before and after treatment for 1 min,2.5min,5min,10min and 15min. If the patient still had shivering after 15min after trearment received, gave tramadol lmg/kg i.v. to stop shivering.ResultsThree patients dropped off the study because using drugs that may affect the result. Both doxapram and pethidine were effective in treating postoperative shivering 2.5-5 min after intravenous administration. In the normal saline group (n=7),7 patients were still shivering 1 min after treatment, whilst in the doxapram group (n=7),3 patients were shivering at that time. In the pethidine group(n=6),5 patients were still shivered by 1 min after treatment. While 2.5min after treatment, doxapram group had 2 patients still shivering, and pethidine group had only 1 patient still shivering compared with all the patients in the normal saline group were still shivering at that time. We conclude that both doxapram and pethidine were effective in treating postoperative shivering. There were 3 patients in the pethidine group versus only 1 patient in the doxapram group encountered postoperative nausea and vomiting. VAS pain score was significantly reduced after treatment in the pethidine group. There were no significant differences among the 3 groups regarding the incidence of respiratory depression or delayed recovery, sedation score or PACU stay time.ConclusionWe conclude that both doxapram and pethidine were effective in the treatment of postoperative shivering. Pethidine may be more effective than doxapram on anti-shivering and postoperative analgesia. But it had higher incidence of postoperative nausea and vomiting.