Prophylactic ondansetron does not prevent shivering or decrease shivering severity during caesarean delivery under combined spinal epidural anaesthesia: a randomized trial

Roger Browning

    Research output: ThesisMaster's Thesis

    252 Downloads (Pure)

    Abstract

    Background and Objectives
    Caesarean delivery is commonly performed under regional anaesthesia, which is often associated with maternal shivering. This can cause maternal distress and interfere with monitoring. The study objective was to evaluate the anti-shivering efficacy of ondansetron, which reduces the incidence and severity of shivering in non-obstetric patients. We hypothesized that there would be a significant decrease in the incidence and/or severity of shivering, from the time of initiating anaesthesia until leaving the post anaesthesia care unit, in women given intravenous ondansetron 8 mg prior to combined spinal epidural anaesthesia, when compared to placebo.
    Methods
    A randomized, double-blinded, parallel-group, placebo-controlled trial of 118 women scheduled for elective caesarean delivery. Women received either intravenous ondansetron 8 mg (n=58) or an equivalent volume of normal saline (n=60) prior to combined spinal epidural anaesthesia (intrathecal hyperbaric bupivacaine 0.5% 2.2-2.5 ml plus fentanyl 15 mcg). The incidence and severity of shivering, the latter measured on a validated 5 point scale, and other outcomes such as nausea, itch, headache or satisfaction, were assessed at three time points during the surgery and postoperative period.
    Results
    The incidence of shivering did not significantly differ between groups at any time: overall ondansetron 41% vs. placebo 47% (p=0.54). The incidence of severe shivering was not significantly different: ondansetron 32% vs. placebo 33% (p=0.79). There were no significant differences between the groups for the secondary outcomes.
    Conclusions
    Intravenous ondansetron 8 mg prior to performing combined spinal epidural anaesthesia in women undergoing elective caesarean delivery does not decrease the incidence or severity of shivering.
    Original languageEnglish
    QualificationMasters
    Publication statusUnpublished - 2014

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