The results showed that , compared with placebo , pethidine , fentanyl , dexmedetomidine , and sufentanil significantly reduced the incidence of perioperative shivering .
In addition , compared with sufentanil , fentanyl showed no impact on haemodynamic stability and the incidence of pruritus .
CONCLUSION Pethidine , fentanyl , dexmedetomidine , and sufentanil appear to be effective for preventing perioperative shivering in puerperae undergoing cesarean sections .
Considering the risk-benefit profiles of the included neuraxial adjuvants , fentanyl is probably the optimal choice
BACKGROUND Perioperative shivering is clinical ly common during cesarean sections under neuraxial anesthesia , and several neuraxial adjuvants are reported to have preventive effects on it .
However , the results of current studies are controversial and the effects of these neuraxial adjuvants remain unclear .
AIM To evaluate the effects of neuraxial adjuvants on perioperative shivering during cesarean sections , thus providing an optimal choice for clinical application .
The effect of adding magnesium sulphate to epidural bupivacaine and fentanyl in elective caesarean section using combined spinal-epidural anaesthesia: a prospective double blind randomised study.
BACKGROUND Combined spinal-epidural anaesthesia is commonly used for elective caesarean section . Intrathecal injection produces rapid onset with minimal doses of local anaesthetic and epidural administration can be used to prolong the block . Our study examined the effects of adding magnesium sulphate to epidural bupivacaine and fentanyl in patients undergoing elective caesarean section using combined spinal-epidural anaesthesia . METHODS Women ASA physical status I or II at term were recruited . All received 2 mL intrathecal 0.5 % hyperbaric bupivacaine , 10 mL epidural 0.25 % plain bupivacaine with fentanyl 100 μg , and were r and omly allocated to receive either 10 mL of epidural 0.9 % sodium chloride or 10 mL epidural 5 % magnesium sulphate .  The quality of surgical anaesthesia , incidence of hypotension , Apgar scores , intraoperative pain assessment , onset of postoperative pain , sedation scores and side effects were recorded in the postoperative period . RESULTS Ninety women were recruited . There was no difference in the time taken for the block to reach T4 sensory level , time to reach the highest level of sensory block , time interval between first neuraxial injection and onset of surgery between the groups . Women who received magnesium had greater motor block and muscle relaxation ( P<0.05 ) . Apgar scores were 7 or more in almost all neonates in both groups . There was no significant difference in the incidence of hypotension , nausea and vomiting and duration of motor blockade between the groups . Women who received magnesium showed less shivering and later onset of post operative pain ( P<0.05 ) . CONCLUSION The addition of magnesium to epidural bupivacaine and fentanyl in women undergoing elective caesarean section with combined spinal-epidural anaesthesia improved intraoperative conditions and the quality of postoperative analgesia
The results showed that , compared with placebo , pethidine , fentanyl , dexmedetomidine , and sufentanil significantly reduced the incidence of perioperative shivering .
In addition , compared with sufentanil , fentanyl showed no impact on haemodynamic stability and the incidence of pruritus .
CONCLUSION Pethidine , fentanyl , dexmedetomidine , and sufentanil appear to be effective for preventing perioperative shivering in puerperae undergoing cesarean sections .
Considering the risk-benefit profiles of the included neuraxial adjuvants , fentanyl is probably the optimal choice
BACKGROUND Perioperative shivering is clinical ly common during cesarean sections under neuraxial anesthesia , and several neuraxial adjuvants are reported to have preventive effects on it .
However , the results of current studies are controversial and the effects of these neuraxial adjuvants remain unclear .
AIM To evaluate the effects of neuraxial adjuvants on perioperative shivering during cesarean sections , thus providing an optimal choice for clinical application .