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 .
Effects of Adding Midazolam and Sufentanil to Intrathecal Bupivacaine on Analgesia Quality and Postoperative Complications in Elective Cesarean Section
Background : Intrathecal adjutants can be used for regional anesthesia ( RA ) in cesarean section to improve its quality in terms of time and complications . Some previous studies focused on the effects of adding sufentanil and /or midazolam to bupivacaine and compared each with using bupivacaine alone . However , there has been no study to assess the effects of using sufentanil and midazolam in combination with bupivacaine . Objectives : The aim of this study was to evaluate and compare properties ( time of achievement/recovery of sensory/motor blocks ; and time to request opium ) , complications ( nausea , vomiting , shivering and hypotension ) , and neonatal first minute Apgar score with and without the addition of midazolam ( M ) or sufentanil ( S ) to bupivacaine ( B ) through intrathecal injection for spinal anesthesia , after the cesarean section . Patients and Methods : In this double blind r and omized clinical trial participants were r and omly allocated to three equal groups : Group B ( 2.5 cc of bupivacaine 0.5 % + 1 cc normal saline 0.9 % ) , Group BM ( 2.5 cc of bupivacaine + 0.02 mg/kg midazolam ) and Group BS ( 2.5 cc of bupivacaine 0.5 % + 0.7 cc normal saline 0.9 % + 1.5 µg of sufentanil , 0.3 cc ) . We used analysis of variance ( ANOVA ) , post hoc test with Bonferroni adjustment , and chi-square test for statistical analysis ; the analyses were performed using the SPSS-16 software . Given a significant level of 0.05 , overall and pair-wise comparisons were made . Results : Seventy-five females participated in the study with no significant age difference ( mean ± st and ard deviation ( SD ) : 28.60 ± 6.06 , 28.12 ± 5.29 and 28.76 ± 3.97 year ; P = 0.9 ) . Except for “ time to motor block recovery ” ( P = 0.057 ) , the overall differences among the three groups was significant in terms of “ time to sensory/motor block ” ( P < 0.001 ) , “ time to sensory block recovery ” ( P < 0.001 ) , and “ time to request opium ” ( P < 0.001 ) . In all pair-wise comparisons there was no significant difference between the BM and BS group , except for “ time to request opium ” , which was longer in the BS group ( P < 0.001 ) . The occurrence of nausea ( P = 0.02 ) , postoperative shivering ( P = 0.01 ) and hypotension ( P < 0.001 ) were significantly different between the groups , unlike vomiting , where the difference was not significant ( P = 0.2 ) . All neonates had an Apgar score of nine . Conclusions : The findings showed that adding sufentanil or midazolam to bupivacaine shortens the onset of spinal anesthesia and increases the time duration of anesthesia ; however it does not change the motor block recovery time . Adding sufentanil delays the first request for narcotic analgesics while adding midazolam leads to a decrease in nausea and hypotension . Adding sufentanil or midazolam does not have any deleterious effect on infants ’ Apgar scores . However , increases shivering in patients
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 .