The Iranian Journal of Obstetrics, Gynecology and Infertility

The Iranian Journal of Obstetrics, Gynecology and Infertility

Effect of intravenous administration of Ondansetrone on prevention of anesthesia-induced shivering in gynecologic surgeries: a randomized clinical trial

Document Type : Original Article

Authors
Farnaz Moslemi 1
Rayhaneh Abri Sardroudi 2
Sevda Arashazad 3
Mohadeseh BijanPour 4
Maryam Sheydaei 3
1 Associate Professor, Department of Anesthesiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
2 Assistant Professor, Department of Anesthesiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
3 Resident, Department of Anesthesiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
4 B.Sc. of Anesthesiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
10.22038/ijogi.2020.16283
Abstract
Introduction: Regarding the safety of Ondansetronecompared to other anti-shivering drugs, its lower side effects and the contradictory results of its use in the prevention of postoperative shivering, this study was performed with aim to evaluate the effect of preoperative intravenous administration of Ondansetroneon prevention of anesthesia-induced shivering in gynecological surgeries.
Methods: This randomized clinical trial study was conducted in 2019 with the participation of 100 women in Alzahra Hospital-Tabriz. Patients were randomly divided into two groups. The intervention group received 2 ml (8 mg) of ondansetroneand the control group received 2 ml of normal saline. The shivering intensity in each patient was recorded according to the shiver severity criterion (LAS). Data were analyzed by SPSS software (version 22) and Chi-square test. P <0.05 was considered statistically significant.
Results: Comparison of the number of cases with shivering after anesthesia indicated that 6 (12%) of the ondansetronegroup and 21 (42%) of the control group had shivering intensity >3 that two groups had statistically significant difference (p= 0.001)
Conclusion: Ondansetrone, as one of the 5-HT3 antagonists, can be effective in preventing shivering after general anesthesia in gynecological surgeries, but it cannot completely inhibit shivering.
Keywords
General anesthesia
Gynecologic surgeries
Ondansetrone
Shivering
  1. Khanbabaei Gol M, Aghamohammadi D. Effect of intravenous infusion of magnesium sulfate on opioid use and hemodynamic status after hysterectomy: double-blind clinical trial. Iran J Obstet Gynecol Infertil 2019; 22(7):32-38.
  2. Sadegh A, Tazeh-Kand NF, Eslami B. Intrathecal fentanyl for prevention of shivering in spinal anesthesia in cesarean section. Med J Islam Repub Iran 2012; 26(2):85-9.
  3. de Figueiredo Locks G. Incidence of shivering after cesarean section under spinal anesthesia with or without intrathecal sufentanil: a randomized study. Rev Bras Anestesiol 2012; 62(5):676-84.
  4. Aghamohamadi D, Gol MK. An Investigation Into the Effects of Magnesium Sulfate on the Complications of Succinylcholine Administration in Nulliparous Women Undergoing Elective Cesarean Section: A Double-Blind Clinical Trial. International Journal of Women’s Health and Reproduction Sciences 2019; 7(4):520-525.
  5. Hannallah M, Carroll J, Charabaty A, Palese C, Barton F, Haddad N. Comparison of propofol versus propofol/fentanyl anesthesia for upper gastrointestinal endoscopy. Anaesthesia, Pain & Intensive Care 2018; 22(2):161-164.
  6. Van de Velde M, Carvalho B. Remifentanil for labor analgesia: an evidence-based narrative review. Int J Obstet Anesth 2016; 25:66-74.
  7. Eleveld DJ, Proost JH, Vereecke H, Absalom AR, Olofsen E, Vuyk J, et al. An allometric model of remifentanil pharmacokinetics and pharmacodynamics. Anesthesiology 2017; 126(6):1005-1018.
  8. Gol MK, Dadashzadeh M, Mohammadipour Anvari H. Design and Implementation of a Checklist for Prediction of Anesthesia-Induced Nausea and Vomiting in Candidate Patients for Mastectomy. International Journal of Women’s Health and Reproduction Sciences 2020; 8(1):90-94.
  9. Gol MK, Aghamohammadi D. Effect of Massage Therapy With and Without Elastic Bandaging on Pain, Edema, and Shoulder Dysfunction After Modified Radical Mastectomy: A Clinical Trial. International Journal of Women’s Health and Reproduction Sciences 2020; 8(1):73-78.
  10. Shen H, Chen Y, Lu KZ, Chen J. Parecoxib for the prevention of shivering after general anesthesia. J Surg Res 2015; 197(1):139-44.
  11. Wiryana M, Sinardja IK, Budiarta IG, Senapathi TGA, Widnyana M, Aryabiantara IW, et al. Effectiveness of infusion warmer use to prevent hypothermia and shivering after general anesthesia. Bali Journal of Anesthesiology 2017; 1(1):10-12.
  12. Vogelsang J, Hayes SR. Butorphanol tartrate (Stadol) relieves postanesthesia shaking more effectively than meperidine (Demerol) or morphine. J Post Anesth Nurs 1992; 7(2):94-100.
  13. Hoshijima H, Takeuchi R, Kuratani N, Nishizawa S, Denawa Y, Shiga T, et al. Incidence of postoperative shivering comparing remifentanil with other opioids: a meta-analysis. J Clin Anesth 2016; 32:300-12.
  14. Martin ET, Kaye KS, Knott C, Nguyen H, Santarossa M, Evans R, et al. Diabetes and risk of surgical site infection: a systematic review and meta-analysis. Infect Control Hosp Epidemiol 2016; 37(1):88-99.
  15. Teymourian H, Mohajerani SA, Bagheri P, Seddighi A, Seddighi AS, Razavian I. Effect of ondansetron on postoperative shivering after craniotomy. World Neurosurg 2015; 84(6):1923-8.
  16. Kelsaka E, Baris S, Karakaya D, Sarıhasan B. Comparison of ondansetron and meperidine for prevention of shivering in patients undergoing spinal anesthesia. Reg Anesth Pain Med 2006; 31(1):40-5.
  17. Powell RM, Buggy DJ. Ondansetron given before induction of anesthesia reduces shivering after general anesthesia. Anesth Analg 2000; 90(6):1423-7.
  18. Fakhari S, Bile Jani I, Atashkhouei S, Khanbabayi Gol M, Soliemanzadeh S. Comparing the effect of hypotension treatment due to spinal anesthesia with ephedrine or phenylephrine on arterial blood gases and neonatal Apgar score during cesarean delivery in obese mothers: randomized clinical trial. Iran J Obstet Gynecol Infertil 2019; 22(10):12-20.
  19. Azami M, Khataee M, Beigom Bigdeli Shamloo M, Abbasalizadeh F, Rahmati S, Abbasalizadeh S, et al. Prevalence and Risk Factors of Hepatitis B Infection in Pregnant Women of Iran: A Systematic Review and Meta-Analysis. Iran J Obstet Gynecol Infertil 2016; 19(18):17-30.
  20. Li M, Hu X, Tan Y, Yang B, Li K, Tang Z. Meta-analysis of randomized controlled trials on the efficacy and safety of ondansetron in preventing postanesthesia shivering. Int J Surg 2016; 35:34-43.
  21. Rai S, Verma S, Pandey HP, Yadav P, Patel A. Role of butorphanol and ondansetron premedication in reducing postoperative shivering after general and spinal anesthesia: A randomized comparative study from North India. Anesth Essays Res 2016; 10(2):319-23.
  22. Abdallah SM. Treatment of postoperative shivering after laparoscopic cholecystectomy under general anesthesia: a comparative clinical study. Al-Azhar Assiut Medical Journal 2019; 17(2):190-197.
  23. Alrjael JF, Attia ZM, Elsawy AH, Abdallah MM. A Comparative Study of Two Different Doses of Intravenous Ondansetron for Prevention of Post-spinal Anesthesia Shivering in Inguinal Hernia Repair Surgery. Zagazig University Medical Journal 2019.
  24. Kamali A, Ahmadi L, Shokrpour M, Pazuki S. Investigation of Ondansetron, Haloperidol, and Dexmedetomidine Efficacy for Prevention of Postoperative Nausea and Vomiting In Patients with Abdominal Hysterectomy. Open Access Maced J Med Sci 2018; 6(9):1659-1663.
The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 23, Issue 4
June 2020
Pages 8-14