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Vol. 63. Issue 9.
Pages 505-512 (November 2016)
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Vol. 63. Issue 9.
Pages 505-512 (November 2016)
Original article
Comparison of the effectiveness of dexmedetomidine, meperidine and ketamine in the prevention of postoperative shivering
Comparación de la eficacia de dexmedetomidina, meperidina y ketamina en la prevención de escalofrío postoperatorio
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F.A. Alvarez Corredor
Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
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Figures (1)
Tables (5)
Table 1. Baseline characteristics of study groups.
Table 2. Characteristics of surgical procedure by intervention group.
Table 3. Results.
Table 4. Intervention-shivering odds ratios.
Table 5. Complications.
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Abstract
Objective

To compare the prophylactic effectiveness of dexmedetomidine, meperidine, and ketamine for postoperative shivering.

Materials and methods

A randomised, controlled, double-blind, clinical trial, including 160 patients (ASA I–II) undergoing surgical procedures under general anaesthesia for longer than 1h. They were randomly assigned to four groups to receive a single intravenous dose: dexmedetomidine 1μg/kg (group A, n=33), meperidine 0.4mg/kg (group B, n=38), ketamine 0.5mg/kg (group C, n=40), or 0.9% saline solution (group D, n=45), administered 20min before the skin suture. To avoid bias, the anaesthetic induction and maintenance technique, as well as postoperative follow-up was standardised.

Results

For any level of shivering, the greatest incidence was observed in the placebo group (47%) (P<.01). The greatest effect on shivering levels 3 and 4 occurred in the placebo group (22% and 18%, respectively). For levels 3 and 4 during follow-up, there was not a single case of shivering at any time in the meperidine group (P<.01). The placebo group (38%) had the highest proportion of patients requiring treatment for post-operative shivering (P<.01).

Conclusion

Meperidine given intravenously in a single dose of 0.4mg/kg is a useful means for preventing postoperative shivering.

Keywords:
Postoperative shivering
Prevention
Dexmedetomidine
Meperidine
Ketamine
General anaesthesia
Resumen
Objetivo

Comparar la eficacia de la dexmedetomidina, meperidina y ketamina profiláctica en el tratamiento del temblor postoperatorio.

Materiales y métodos

Ensayo clínico, aleatorizado, controlado y de doble ciego. El estudio incluyó 160 pacientes (ASA I-II) bajo anestesia general mayor a 1h de duración. Se asignaron aleatoriamente a 4 grupos para recibir dosis única intravenosa: dexmedetomidina 1μg/kg (grupo A, n=33), meperidina 0,4mg/kg (grupo B, n=38), ketamina 0,5mg/kg (grupoC, n=40), o solución salina 0,9% (grupo D, n=45), administrados 20min antes de la sutura de piel. Para evitar sesgos, se estandarizó la técnica de inducción y mantenimiento anestésico así como el seguimiento postoperatorio.

Resultados

Para cualquier grado de escalofrío, la mayor incidencia se presentó en el grupo placebo (47%) (p<0,01). La mayor incidencia para escalofrío (grados 3 y 4) se presentó en el grupo placebo (22 y 18% respectivamente). Para los grados 3 y 4 en todos los momentos de seguimiento no se presentó ningún caso de escalofrío en el grupo de meperidina (p<0,01). El grupo placebo (38%) fue el que mayor proporción de pacientes requirió tratamiento de rescate para escalofrío postoperatorio (p<0,01).

Conclusión

La meperidina en dosis única de 0,4mg/kg intravenosa es una medida útil para la prevención del escalofrío postoperatorio.

Palabras clave:
Escalofrío postoperatorio
Prevención
Dexmedetomidina
Meperidina
Ketamina
Anestesia general

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