The efficacy of ondansetron in comparison with pethidine for prevention of shivering in pregnant patients undergoing a cesarean sectionwith spinal anesthesia

Abstract

Postanesthetic shivering (POS) is a common complication following spinal anesthesia. Several
drugs have been used to prevent POS, including ondansetron and pethidine. This study was
conducted to compare the efficacy of ondansetron 8 mg with pethidine 0.4 mg/kg BW for
prevention of shivering in pregnant patients undergoing a cesarean section with spinal anesthesia.
This is a double blind controlled trial involving 96 pregnant patients between the age 18-40
years with ASA physical status I-II, gestational age of 37-42 weeks, body weight of 40-70kg or
Body Mass Index (BMI) <30, body height >145 cm who underwent a cesarean section with
spinal anesthesia in Dr. Sardjito General Hospital, Yogyakarta and affiliated hospital. Exclusion
criteria included patients or families who refused to participate in the study, having a history of
allergy to bupivacaine, ondansetron, and pethidin, patients with a fetus known to have congenital
abnormalities earlier, body temperature early > 38 ºC or <36 ºC, pregnancy with complications
(PEB, eclampsia, HELLP syndrome), and pregnant patients with heart disease (severe hypertension,
heart trouble, abnormal heart valves). The patients were randomized into two groups i.e. 48
patients of group ondansentron receiving intravenous ondansetron 8 mg and 48 patients of
group pethidine receiving intravenous pethidine 0.4 mg/kg BW. The patients were observed for
occurence and severity of POS, postoperative nausea and vomiting. The results showed that
two patients (4.2%) on the ondansetron group and six patients (12.5%) on the pethidine group
experienced of POS. Moreover, the efficacy of ondansetron in the prevention of POS (95.8%)
was higher than pethidine (87.5%). However, there were not significantly different (p>0.05).
The incidence of nausea on the ondansetron group (4.2%) was lower than the pethidine group
(16.7%) (p<0.05). However, no significant difference in the incidences of vomiting was observed
between the ondansetron (0%) dan the pethidine (4.2%) groups (p>0.05). In conclusion, the
efficacy of ondansetron 8 mg is comparable to pethidine 0.4 mg/kgBW for prevention of shivering
in pregnant patients after spinal anesthesia.