Efficacy of pethidine 0.1 and 0.2 mg/kg body weight as an adjuvant of intrathecal bupivacaine 0.5% 10 mg in preventing shivering

Abstract

Shivering related with spinal anesthesia commonly occurs in patients. It is not only uncomfortable
for the patients, but also related to some complication. The efficacy of pethidine in the prevention
of shivering is well known. The aim of this study was to compare the efficacy of intrathecal
pethidine 0.1 mg/kg body weight (BW) and 0.2 mg/kg BW as shivering-prevention drug after
spinal anesthesia. This was a randomized, double-blind controlled trial study involving 196
subjects between the age 18-40 years with ASA physical status I-II, gestional age 37-42 weeks,
BW of 40-70 kg or Body Mass Index (BMI) <30 kg/m2, body height >145 cm who underwent a
caesarean delivery section with spinal anesthesia based of World Health Organization (WHO)
procedure in cesarean delivery in Dr. Sardjito General Hospital, Yogyakarta and affiliated hospital.
Subjects were divided into two groups with 98 subjects of each group. Group A was given an
hyperbaric 0.5% bupivacaine 10 mg and pethidine 0.1 mg/kg BW, and Group B was given an
hyperbaric 0.5% bupivacaine 10 mg and pethidine 0.2 mg/kg BW in the same volume (2.5 mL).
The seubjects were observed for the incidence and severity of shivering and side effects of
pehtidine. The results showed that the incidence of shivering in Group A (35.70%) was significantly
greater than in Group B (22.44%) (p<0.05). However, the onzet an duration of shivering were
not significantly different in both groups (p>0.05). Moreover, the incidence of nausea and
vomiting in Group A (8.33%) was significantly lower than Group B (22.45%). In conclusion,
pethidine 0.2 mg/kg BW is more effective to preven shivering than pethidine 0.1 mg/kg BW
although the incidence of its side effects is more higher.