Study Of The Prevention Of Post-Operative Shivering After Sevoflurane Anaesthesia Following Preoperative Use Of Pethidine, Buprenorphine And Butorphanol Intravenously In Small Doses And Comparison Of Their Effects
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 1
Abstract
A significant number of patients, undergoing Sevoflurane and or Propofol anaesthesia, may develop shivering and hypoxemia, in the immediate post-operative period. However in majority of patients this is relieved spontaneously after some time in fit and healthy patients - no serious problem is posed. As post-anaesthetic shivering increase metabolic rate, oxygen (O2) demand and carbon-di-oxide (CO2) production, it may become hazardous in compromised patient population. Several physical and pharmacological approaches to treatment and prevention of post-anaesthetic shivering have been studied. Pethidine in a low dose has been found to be the most effective and consistent drug in stopping post-anaesthetic shivering. Confusing reports are found in the literature regarding the role of other opioids e.g. Fentanyl in treating post-anaesthetic shivering. Hence, this prospective, randomized, double blind study was conducted in 90 ASA-I patients undergoing operation under general anaesthesia, lasting not more than 1 hour. The patients were divided into 3 groups, – Group-I received Pethidine, Group-II received Buprenorphine and Group-III received Butorphanol. Identical anaesthetic technique was employed for all the patients, namely induction with propofol and maintaining anaesthesia with sevoflurane upto 3vol% using Mapleson-A circuit for spontaneous ventilation. Ambient temperature of operation theatre(OT) and recovery room and temperature of intravenous (IV) fluid were maintained around 30oC. Heart rate, core temperature, oxygen saturation and end-tidal CO2(ETCO2) were recorded intra-operatively and post-operatively from time to time. Arterial blood gases of shivered patients were done. After proper statistical analysis of the data obtained following observations were found: 1) No correlation could be established between incidence of shivering and the age or body weight of the patient. 2) Overall incidence of shivering 14.44%. 3) No statistical significant difference was obtained in the change of intra-operative and post-operative heart rate as well as intra-operative and post-operative core body temperature. 4) Median value of post-operative arterial oxygen saturation was 99% in all three groups and median value of post-operative ETCO2 was 35mm of Hg in all three groups. There changes could not present any statistical significance. So hypoxia was not statistically significant.
Authors and Affiliations
DrGunadhar Jana, DrSudakshina Roy, Dr. Debarshi Jana
Keywords
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- EP ID EP446207
- DOI 10.9790/0853-1801173646.
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