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 .
Efficacy of lipophilic vs lipophobic opioids in addition to hyperbaric bupivacaine for patients undergoing lower segment caeserean section
Background : Subarachnoid block is the preferred technique for providing anesthesia for patients undergoing cesarean section . Various pharmacological agents in added to local anesthetics ( LA ) modify their original effects in terms of block characteristics and quality of analgesia . However , there is ongoing debate about this practice of using adjuncts with LA . We tested whether addition of lipophilic versus lipophobic opioids to LA gives any clinical benefits to maternal and fetal outcome when used in these patients requiring spinal anesthesia . Subjects and Methods : Sixty American Society of Anesthesiologists I and II parturients , undergoing elective cesarean section requiring subarachnoid block , were included in our study . The parturients were allocated r and omly to three groups of 20 each to receive bupivacaine 12.5 mg ( Group I ) , bupivacaine 12.5 mg + morphine 0.2 mg ( Group II ) , bupivacaine 12.5 mg + fentanyl 25 μg ( Group III ) , preservative free physiological saline 0.9 % was added to all the solutions to achieve a total volume of 4 ml . The parameters studied were the time of onset , sensory level of the block achieved , total duration of analgesia , any need of rescue analgesics , maternal side effects , and fetal outcome . Results : Onset of block was early 4.30 ± 0.12 min in Group III as compared to Group I 4.64 ± 0.28 min and Group II 4.505 ± 0.22 min . Mean duration of analgesia ( hours ) was higher in Group II 15.91 ± 0.96 h as compared to Group I 1.95 ± 0.55 h and Group III 4.39 ± 0.2 h. Incidence of nausea , vomiting , and shivering was more in the control group as compared to study groups , whereas sedation and pruritus were seen more in the study groups . No adverse effects on fetus were seen with use of opioids and comparable Apgar scores were noted . Conclusion : Addition of intrthecal fentanyl causes rapid onset of block whereas intrathecal morphine provides prolonged analgesia with comparable neonatal wellbeing
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 .