Effectiveness of Prophylactic Ketamine on Shivering in Cesarean Section after Spinal Anesthesia

Muhammad Hamood Farooqi; Kashif Naeem; Aimen Zafar; Qamar Zaman Phull; Hira Saeed Khan; Shujaullah Talib

doi:10.29054/apmc/2023.1220

Muhammad Hamood Farooqi Senior Registrar, Department of Anesthesia, Baqai Medical University Hospital, Karachi Pakistan
Kashif Naeem Consultant Anesthetist, Indus Hospital, Karachi Pakistan
Aimen Zafar Senior Registrar, Department of Anesthesia, Baqai Medical University Hospital, Karachi Pakistan
Qamar Zaman Phull Assistant Professor, Department of Pharmacology, Bilawal Medical College for Boys LUMHS, Jamshoro Pakistan
Hira Saeed Khan Assistant Professor, Department of Physiology, Suleman Roshan Medical College, Tando Adam Pakistan
Shujaullah Talib Assistant Professor, Department of Pharmacology, Muhammad Medical College, Mirpur Khas Pakistan

DOI: https://doi.org/10.29054/apmc/2023.1220

Keywords: Ketamine, Shivering, Spinal anesthesia

Abstract

Background: Regional anesthesia, including spinal or epidural techniques, can disrupt the body's ability to regulate temperature, leading to a heightened risk of shivering. Studies have indicated that shivering occurs in up to 55% of patients undergoing procedures under regional anesthesia. To address this issue, numerous medications have been explored for their potential to prevent post-anesthetic shivering. Objective: To assess the effectiveness of prophylactic ketamine on shivering in cesarean section after spinal anesthesia. Study Design: Prospective, randomized, double blind, clinical trial.

Settings: Department of Anesthesiology, Surgical Intensive Care Unit and Pain Management, Civil Hospital Karachi Pakistan. Duration: Six months from August 2019 to January 2020. Methods: A total of 60 patients undergoing spinal anesthesia for elective cesarean section were included in this study. Two groups A and B were formed and patients were equally divided into these groups by lottery method. Group A were treated with ketamine 0.5 mg/kg I/V and group B treated with normal saline 0.05ml/kg/I/V. Grade 0-1 shivering was labeled as effective and shivering grade 2, 3 or 4 at 15 minutes after administration of the drug, was considered ineffective. Results: The average age of the patients was 28.33 ± 5.67 Years. Rate of shivering was significantly high in patients who were treated with normal saline than ketamine in which shivering was not observed (53.3 vs. 0% respectively; P value of 0.0005). This implies that effectiveness was significantly high in groups A than group B (100% vs. 46.7%). Conclusion: Ketamine observed to be the effective drug for the treatment of postanesthetic shivering. It should be considered prophylactically in any patient undergoing spinal anesthesia.