Turkish Journal of Anaesthesiology & Reanimation
ORIGINAL ARTICLE

Efficacy of prophylactic ketamine, ondansetron, and pethidine in preventing perioperative shivering in patients undergoing elective knee replacement surgery under spinal anaesthesia

1.

Department of Anesthesiology & Critical Care, AICTS, Pune, India

2.

Department of Anaesthesiologist & Critical Care, Army Hospital Research & Referral, New Delhi, India

3.

Department of Anaestheiologist & Critical Care, Armed forces Medical College, Pune, India

Turk J Anaesthesiol Reanim 1; 1: -
DOI: 10.5152/TJAR.2021.20444
Read: 262 Downloads: 111 Published: 11 May 2021

Objectives: Perioperative shivering (POS) is a very common complication during surgery. Despite the vast array of knowledge regarding POS and its after-effects, its prophylaxis is often overlooked. The study aims to compare the efficacy and safety of low dose Ketamine, Ondansetron, and Pethidine in the prevention of POS in patients undergoing total knee replacement (TKR) surgery under the subarachnoid block (SAB).

Methods: In this randomized controlled study, 203 patients aged 18-75 were included and allocated to one of the 4 groups; Normal saline (Group S), Ondansetron 4mg (Group O), Ketamine 0.25mg kg-1 (Group K), and Pethidine 0.25mg kg-1 (Group P). Side effects namely hypotension, nausea and vomiting, sedation and hallucinations, and respiratory depression were recorded.

Results: POS was present in 22(44%), 8(16%), 4(7.84%), and 4(7.69%) patients respectively in Group S, O, K, and P which was statistically significant when compared to Group K (p<0.01). No difference in the incidence of hypothermia was observed across the groups (p<0.17). A significantly lower incidence of hypotension was observed in group K. 5.9% of Patients found to be in severe sedation score in group K. There was no incidence of hallucination and respiratory depression observed in any of the groups.

Conclusion: Patients undergoing TKR surgeries are highly predisposed to the development of hypothermia. It is thus imperative that temperature monitoring to be done in all patients. Prophylactic administration of low dose ketamine or Ondansetron or low dose pethidine produces significant antishivering effect without any significant side effects. However low dose Ketamine has the advantages of a lower incidence of hypotension and nausea vomiting than with using pethidine.

Cite this article as: Ramanathan R, Sethi R, Singh S, et al. Efficacy of prophylactic ketamine, ondansetron, and pethidine in preventing perioperative shivering in patients undergoing elective knee replacement surgery under spinal anaesthesia. Turk J Anaesthesiol Reanim. 2021; doi: 10.5152/TJAR.2021.20444

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