Effectiveness of Ephedrine for the prevention of postoperative shivering after general anesthesia

Authors

  • Chonrat Kantanabat

Keywords:

Ephedrine, general anesthesia, shivering prevention

Abstract

Postoperative shivering after general anesthesia is a common side effect among patients with increased oxygen consumption. This event may increase the risk of myocardial infraction, acidemia, and discomfort for the patients. Therefore, this study aims to compare the efficacy of prophylactic ephedrine and a placebo for the prevention of shivering caused by general anesthesia. A randomized control trial of 108 patients with an ASA status of 1-3 had surgery under general anesthesia. The patients were randomly allocated to receive normal saline (n=54) or ephedrine 9 mg. (n=54) intravenously. The vital signs, tympanic temperature, shivering score and side effects, i.e., hypertension and tachycardia were also recorded. The results revealed that the incidence of postoperative shivering was significantly less than in the ephedrine group (p=0.006). The number of patients with a score of three on the shivering scale was significantly higher in the normal saline group (p=0.020). The mean tympanic temperature fell in both groups and more significantly in the normal saline group (p<0.001). Therefore, the prophylactic use of ephedrine is effective for the prevention of postoperative shivering without causing any major side-effects.

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References

1. Tunprasit C, Dusitkasem S, Khakhuy C, et al. Efficacy of post intubation dexmedetomidine infusion for prevention of postoperative shivering.Thai J Anesthesiol 2016;42:139-48.
2. El-Deeb A, Barakat R. Could ephedrine replace meperidine for prevention of shivering in women undergoing cesarean section under spinal anesthesia? A randomized study. Egyptian J Anaesth 2012;28:237-41.
3. Pravitharangul T, Karnjanarachata C, สAreeruk P, et al. Single bolus intravenous ephedrine attenuates reduction of core body temperature in patients undergoing spinal anesthesia for arthroscopic knee and ankle surgery. J Med Assoc Thai 2020;103:134-40.
4. Jo YY, Kim JY, Kim JS, et al. The effect of ephedrine on intraoperative hypothermia. Korean J Anesthesiol 2011;60:250-4.
5. Pravitharangul T, Koopinpaitoon W, Kraisen R, et al. Ephedrine and propofolfor induction of general anesthesia can decrease intraoperative hypothermia in patients undergoing plastic and breast surgery: a randomized, controlled trial. Asian Biomedicine 2015;9:379-85.
6. Gullhas N, Tekdemir D, Durmus M, et al. The effect of ephedrine on maternal hypothermia in cesarean sections: a double blind randomized clinical trial. Eur Rev Med Pharmacol Sci 2013;17:2051-8.
7. Daabiss MA. Ephedrine-dexamethasone combination reduces postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy. Int J Anesth 2008:18.
8. Wuhrman E, Clark M. Use of ephedrine foe the short-term treatment of postoperative nausea and vomiting: a case report. J Perianesth Nurs 2011;26:
305-9.
9. Sessler DI. Perioperative thermoregulation and heat balance. Ann N Y Acad Sci 1997; 813:757-77.
10. Sessler DI. Perioperative heat balance. Anesthesiology 2000;92:578-96.
11. Dulloo AG, Seydoux J, Girardier L. Peripheral mechanisms of thermogenesis induced by ephedrine and caffeine in brown adipose tissue. Int J Obes
1991;15:317-26.
12. Crossley AW. Peri-operative shivering. Anesthesia 1992;47:193-5.
13. Bhattacharya P, Bhattacharya L, Jain R, et al. Post anesthesia shivering (PAS): a review. Indian J Anaesth 2003;47:88-93.
14. Kiekkas P, Poulopoulou M, Papahatzi A, et al. Effect of hypothermia and shivering on standard PACU monitoring of patients. AANA J 2005;73:47-53.
15. Buggy DJ, Crossley AW. Thermoregulation, mild perioperative hypothermia and postanaesthetic shivering. Br J Anaesth 2000;84:615-28.
16. Eberhart LH, Doderlein F, Eisenheardt G, et al. Independent risk factors for postoperative shivering. Anesth analg 2005;101:1849-57.
17. Pisitsak C, Virankabutra T, Deewong K, et al. Postoperative hypothermia: incidence and associated factors. Thai J Anesthesiol 2011;37:93-103.
18. Kranke P, Eberhart LH, Roewer N. Pharmacological treatment of postoperative shivering: a quantitative systematic review of randomized controlled trials. Anesth
Analg 2002;94:453-60.

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Published

2021-08-31

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Original Article (บทความวิจัย)