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 .
Subarachnoid Fentanyl Augments Lidocaine Spinal Anesthesia for Cesarean Delivery
Background and Objectives . Fentanyl at doses of 6.25 μg or more , when added to hyperbaric bupivacaine for spinal anesthesia for cesarean delivery , has been reported to markedly increase the duration of analgesia . In this study , subarachnoid fentanyl 15 μg was evaluated as the sole adjunct to hyperbaric lidocaine spinal anesthesia in parturients undergoing cesarean delivery at term , to determine its effect on the duration of analgesia and side effects perioperatively . Methods . Twenty-eight parturients scheduled for elective cesarean delivery at term were r and omized to one of two groups in a prospect i ve , double-blind fashion . Patients in group F received 15 μg fentanyl in addition to 80 mg hyperbaric lidocaine for subarachnoid anesthesia , while patients in group N received 0.3 mL normal saline in addition to 80 mg hyperbaric lidocaine . Visual analog pain scores were recorded preoperatively and at regular intervals until the first patient request for additional analgesia . The occurrence of side effects ( nausea , vomiting , pruritus , shivering ) was recorded at intervals for 4 hours postinduction . All patients received patient-controlled analgesia after delivery , and analgesic requirements for 24 hours postinduction were recorded . Results . There was no difference between groups with respect to visual analog pain scores intraoperatively . The mean duration of effective analgesia was increased in the patients receiving fentanyl from 71 minutes to 101 minutes ( Student 's t-test , P < .01 ) . No difference was observed between groups with regard to 4-hour or 24-hour analgesic requirements . Patients in group F were significantly less likely to experience nausea ( Fisher 's exact test , P < .05 ) and vomiting ( chi-square test , P < .05 ) in the immediate perioperative period , but no differences were noted between groups in the incidence of pruritus or shivering . Conclusions . The addition of fentanyl 15 μg to hyperbaric lidocaine for subarachnoid anesthesia for cesarean delivery increases the duration of effective analgesia by approximately 30 minutes compared to plain hyperbaric lidocaine , and provides a protective effect regarding nausea and vomiting in the perioperative period
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 .