Intravenous Dexamethasone Versus Meperidine in the Prevention of Post- Spinal Shivering in Urological Surgery Patients a Randomized Control Trial at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia, 2024 G.C.
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Date
2024-05
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Addis Ababa University
Abstract
Background: Shivering is defined as an involuntary, oscillatory skeletal muscular action that increases oxygen consumption (200%–500%) and carbon dioxide production, resulting in arterial hypoxemia, lactic acidosis, and a rise in intraocular and intracranial pressure. It's one of the complications that decrease patient satisfaction.There are both preventive and management measures for shivering; meperidine (pethidine) is the first line agent; and there are also other classes of drugs that have proven to be effective, such as alpha-2 agonists, tramadol, dexamethasone, ketamine,and ondansetron. In this study, dexamethasone will be compared with pethidine.
Objective; was to compare the efficacy of dexamethasone versus pethidine in the prevention of post-spinal shivering at the Black Lion Hospital in Addis, Ethiopia.
Method; institutional based single blinded randomized control trial, the study was conducted at Addis Ababa University School of health science which is found in Addis Ababa. The source population will be all elective patients undergoing surgery under neuraxial anesthesia. The final sample size for this study is 56. The data will be collected intraoperatively using a pretested questioner by trained data collectors. Data will be checked for completeness and entered using Epi-info software and cleaned then imported to SPSS 27 software for analysis. Descriptive analysis will be done for the Socio-demographic and clinical characteristics of the participants. independent t test for comparison of continuous variable and chi square test for categorical variables used for analysis. The association considered significant when a p value is less than 5% at 95% confidence interval
Result - Total incidence of shivering is 28% and dexamethasone group has 36%, pethidine group has 20% with p value (0.18). From intraoperative variables systolic blood pressure has significant reduction in pethidine group p value (0.001). Moderate to severe shivering was seen in 6 (19%) patients in dexamethasone group while 2(6.7%) patients in pethidine group had moderate shivering. 2 patients from dexamethasone group required rescue management. Nausea is seen in 5 patients from pethidine group and 2 patients from dexamethasone group. None of the patients had vomiting or hypotension.
Conclusion – Intravenous 0.1 mg dexamethasone is as effective as intravenous pethidine for prevention of visible muscular shivering with reduced incidence of complication.
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Keywords
Shivering, Urological surgery