Shivering and changes in body temperature in patients undergoing caesarean section under spinal anaesthesia with bupivacaine vs bupivacaine and fentanyl: A randomized clinical study

• Published in: Journal of anaesthesiology, clinical pharmacology clinical pharmacology, 2023-01, Vol.39 (1), p.67-73
• Main Authors: Thakur, Niraj, Balachander, Hemavathi, Rudingwa, Priya, Panneerselvam, Sakthirajan
• Format: Article
• Language: English
• Subjects: Anesthesia; Bupivacaine; Cesarean section; Clinical trials; fentanyl; Hypothermia; Original; shivering; spinal anesthesia; Sufentanil
• ISSN: 0970-9185; 2231-2730
• DOI: 10.4103/joacp.joacp_156_21

Background and Aims: Shivering is common after spinal anesthesia in patients undergoing cesarean section. Various drugs have been used for its prevention. The primary aim of this study was to assess the efficacy of adding a small dose of fentanyl intrathecally (12.5 μg) in reducing the occurrence of intraoperative shivering and hypothermia and note any significant side effects in this subset of patients. Material and Methods: In this randomized controlled trial, 148 patients undergoing cesarean section under spinal anesthesia were included. In 74 patients, spinal anesthesia was administered with 1.8 mL of hyperbaric bupivacaine (0.5%), and the remaining 74 patients received 12.5 μg of intrathecal fentanyl with 1.8 mL of hyperbaric bupivacaine. Both were compared to find the incidence of shivering and change in nasopharyngeal and peripheral temperature along with the temperature at the onset of shivering and the grade of shivering. Results: The incidence of shivering was 9.46% in the intrathecal bupivacaine plus fentanyl group, which was significantly less than the group with intrathecal bupivacaine alone (41.89%). The nasopharyngeal and peripheral temperature showed a decreasing trend in both groups but were greater in the plain bupivacaine group. Conclusion: The addition of 12.5 μg of intrathecal fentanyl to bupivacaine in parturient undergoing cesarean section under spinal anesthesia significantly reduces the occurrence and intensity of shivering without its adverse effects such as nausea, vomiting, and pruritus, etc.