Compare the Effectiveness of prophylactic intravenous ketamine 0.5mg/kg and pethidine 0.5mg/kg for postoperative shivering in patients undergoing elective surgery under general anesthesia at Tikur Anbessa specialized hospital, Addis Ababa Ethiopia, from January 01 to April 30, 2018: A prospective observational cohort study
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Date
2018-06
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Addis Ababa Universty
Abstract
Background: Post anesthesia shivering is one of the potential complications of anesthesia which
may increase patient’s morbidity. Nowadays, it has become a common phenomenon with the
increasing number of surgeries. Various pharmacological and non-pharmacological methods had
been employed to control postoperative shivering. Warming the patient and other alternative
methods has been employed over several years, but it was more expensive.
Objectives: to compare the effectiveness of intravenous ketamine 0.5mg/kg and pethidine 0.5
mg/kg for post-operative shivering after general anesthesia at black lion specialized hospital
from January 1 to April 30, 2018.
Methods and materials: an observational cohort study was conducted at black lion specialized
hospital from January 1 to April 30, 2018. The study involved 76 ASA I and II patients aged 18-
65 years, undergoing elective surgery under general anesthesia. The patients in the two groups
took either ketamine 0.5mg/kg and pethidine 0.5 mg/kg 20 minutes before completion of the
surgery. The incidence and severity of post-operative shivering were compared between the two
groups every 10 minutes until one hour postoperatively. Categorical data were analyzed with the
Chi-Square test and fisher exact test. Parametric data between groups were analyzed using
independent samples t-test and non-parametric data were analyzed with Mann-Whitney U test. A
p value of <0.05 was considered as a statistically significant.
Results: The incidence of shivering between the ketamine and pethidine groups in PACU were
(28.2%) and (35.9%) respectively (p=0.467). Grades of shivering were not significantly different
between the two groups (p=0.893). Comparison of HR and MAP at different time intervals
intraoperatively was found to be comparable between the groups (p>0.05). The scores of axillary
temperature at different time intervals during intraoperative and postoperative period have shown
comparable values.
Conclusion and Recommendation: This study showed that prophylactic low dose IV ketamine
reduced postoperative shivering as effectively as pethidine. The study also showed a clinically
better outcome in favor of ketamine. We recommend prophylactic low dose IV ketamine 20
minutes before completion of surgery to prevent postoperative shivering.
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Keywords
ketamine, pethidine, general anesthesia, postoperative shivering, elective surgery