The role of ramosetron in the prevention of post-spinal shivering in obstetric patients. A prospective randomized double blind study
Rohit Kumar Varshney1, Megha Garg2, Kali Kapoor1, Gurdeep Singh Jheetay1
1 Department of Anaesthesia, Teerthankar Mahaveer Medical College, Moradabad, U.P., India
2 Department of Pharmacy, Teerthanker Mahaveer College of Pharmacy, Moradabad, U.P., India
Background and Aim: Intra/post-operative shivering is frequently observed in parturients posted for elective cesarean delivery (C/D) under spinal anaesthesia. Several studies have advocated the anti-shivering effect of 5-HT3 antagonists, although none has revealed convincing results. The study aims to evaluate the prophylactic effect of a single intravenous dose of ramosetron (0.3 mg), compared with a placebo (N – normal saline), for the prevention of post-spinal shivering (PSS) during elective C/D.
Method: The study comprised 80 parturients of the American Society of Anaesthesiologists (ASA) physical status I/ II, posted for elective C/D under spinal anaesthesia who were randomly divided into 2 equal groups; Group N: 0.9% normal saline (4 ml) immediately before induction of spinal anaesthesia and Group R: ramosetron (0.3 mg) intravenously diluted to 4 ml volume. Shivering at any time on a (0-4) scale and total dose of tramadol required for its treatment was recorded. The study also includes the recording of haemodynamic parameters and the incidence of early onset nausea and vomiting.
Results: Statistically significant data was obtained while comparing incidence of shivering and maximum shivering at any time (P = 0.001). A lower incidence of early onset nausea and decreased total dose of tramadol was also observed in the ramosetron group.
Conclusion: Ramosetron (0.3 mg) is advocated to be an effective drug in preventing post-spinal shivering among parturients posted for elective C/D. Moreover, its role in preventing maternal nausea together with better haemodynamic parameters further supported the advantageous role of ramosetron in our group of patients.
Keywords: cesarean section, post-spinal shivering, ramosetron