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 .
Shivering following cardiac surgery: hemodynamic changes and reversal.
The effects of shivering on hemodynamics and systemic oxygenation , as well as the effectiveness of therapeutic interventions in decreasing shivering and increasing mixed venous oxygen saturation , were studied . Thirty adult patients undergoing cardiopulmonary bypass with systemic hypothermia were observed for 1 1/2 to 5 hours postoperatively for signs of shivering associated with a simultaneous decrease in oxygen transport . Systemic and pulmonary hemodynamic measurements were made , blood temperature and mixed venous oxygen saturation were monitored via the pulmonary arterial catheter , and oxygen consumption and delivery were calculated . Shivering was grade d by a single investigator on scale of 0 to 4 , with 0 = no shivering and 4 = continuous violent muscle activity . Therapy was instituted when shivering reached grade 4 or when SvO2 decreased to less than two thirds of its value on arrival in the intensive care unit ( ICU ) . Patients were r and omly assigned to receive either morphine sulfate , 5 to 10 mg , or meperidine , 25 to 50 mg intravenously ( IV ) , followed by the other narcotic if the initial drug failed to improve SvO2 or decrease shivering within ten minutes . The end-point for successful treatment was a return of SvO2 to within 5 % to 10 % of its value upon arrival in the ICU or a cessation of shivering that did not recur within 45 minutes . Twenty of the thirty patients shivered sufficiently to decrease SvO2 by more than one third of its initial value , thus requiring pharmacologic therapy . As shivering increased from a score of 0.8 + /- 1.1 to 3.4 + /- 0.9 , SvO2 decreased from 74 + /- 6 % to 57 + /- 12 % . ( ABSTRACT TRUNCATED AT 250 WORDS
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 .