Background and Aims: Hypothermia is considered a common problem with
anesthesia. Spinal anesthesia, affects the process of temperature regulation.
The aim of this study was to compare the prophylactic effect of intravenous
(IV) meperidine with intrathecal (IT) meperidine on the prevention of shivering during spinal anesthesia in patients underwent knee arthroscopy. Aim
of the Study: The aim of this work is to study the effect of meperidine either
intravenous (IV) vs intrathecal (IT) on controlling postoperative shriving after knee arthroscopy. Materials and Methods: This study will be conducted
in accordance with the principles of the ethics committee Benha University
hospitals. Full written informed consent will be obtained from all patients
before inclusion in the study, and a prospective randomized double-blinded
study was conducted in adult patients undergoing knee arthroscopy under
spinal anesthesia. Cases are divided into three equal groups (20 patients in
each). Group IT: will receive spinal anesthesia (12.5 mg heavy bupivacaine)
with intrathecal meperidine (25 mg). Group IV: will receive spinal anesthesia
(12.5 mg heavy bupivacaine) with intravenous meperidine (25 mg). Group C:
will receive spinal anesthesia (12.5 mg heavy bupivacaine) only postoperatively. Incidence and degree of shivering (SS), sedation score (RSS), pain
score (VAS), hemodynamics, and PONV will be measured at the following
intervals: 0 min (once arrived at PACU), 20 min later, 40 min later, 80 min
later. Results: Shivering was observed in 0%, 0%, and 10.5% of patients in
Groups IT, IV, and C, respectively. There was a significant difference between
Group IT and IV compared to Group C (P < 0.001). Shivering incidence and
intensity in IT group and IV group was significantly lower than C group (P <
0.001). There was a better postoperative pain control in IT group than IV
group, and also IT group was showed less side effects as it showed less PONV
than IV group. Conclusion: We concluded that IT meperidine and IV mepe ridine comparably can decrease intensity and incidence of shivering compared to control group as well as decrease the requirement for additional
doses of meperidine for shivering control without any hemodynamic side effect. And intrathecal meperidine showed better postoperative pain control
and less postoperative nausea and vomiting (PONV). |
