COMPARATIVE EFFICACY OF INTRAVENOUS MIDAZOLAM, MIDAZOLAM-KETAMINE, AND KETAMINE IN REDUCING THE PREVALENCE OF POST-SPINAL SHIVERING: A DOUBLE-BLIND CLINICAL TRIAL | ||||
| Bulletin of Pharmaceutical Sciences Assiut University | ||||
| Volume 47, Issue 2, December 2024, Page 1105-1117 PDF (840.62 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/bfsa.2024.275448.2056 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
Siavash Sangi  1; Nasim Alipour2; Nahid Manouchehrian3; Maryam Aligholizadeh1
| ||||
| 1MSc of Anesthesia Education Student, Department of Anesthesia Technology, School of Allied Medical Sciences, Iran University of Medical Sciences, Tehran, Iran | ||||
| 2PhD Candidate in Nursing, Student Research Center, School of Nursing and Midwifery, Kermanshah University of Medical Science, Kermanshah, Iran | ||||
| 3Department of Anesthesiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran | ||||
| Abstract | ||||
| Background: Post-spinal shivering poses a common challenge following regional anesthesia, presenting patients with an undesirable and distressing experience, and potentially leading to various complications. This study aimed to investigate the efficacy of intravenous midazolam, midazolam-ketamine, and ketamine in reducing the incidence of post-spinal shivering. Methods and materials: A double-blind clinical trial was conducted on 124 patients aged 18-40 undergoing cesarean section with spinal anesthesia at Fatemieh Hospital, Hamadan. Spinal anesthesia was induced with 0.5% bupivacaine (10 mg) plus 2.5 μg sufentanil. Patients were randomly assigned to four groups: Midazolam 0.075 mg/kg (Group A), Ketamine 0.5 mg/kg (Group B), Ketamine 25.0 mg/kg plus Midazolam 37.5 μg/kg (Group C), and Normal saline 0.9% (Group D). Shivering severity, hemodynamic effects, nausea and vomiting, arterial oxygen saturation, hallucinations, sedation, and pethidine consumption were recorded during surgery and recovery. Results: There were no statistically significant differences in shivering severity among the four groups. Additionally, no significant disparities were observed in hallucination occurrence or pethidine consumption. However, notable physiological changes were noted, including reductions in systolic and diastolic blood pressure, mean arterial pressure, and arterial oxygen saturation across all groups. Moreover, the midazolam-ketamine group exhibited increased heart rate and sedation scores, along with a higher incidence of nausea and vomiting. These findings highlight the diverse effects of the interventions on various physiological parameters and patient experiences. Conclusion: Prompt administration of pharmacological agents following regional anesthesia may offer a more effective approach to prevent post-spinal shivering. | ||||
| Keywords | ||||
| Shivering; Ketamine; Midazolam; Spinal Anesthesia | ||||
|
Statistics Article View: 394 PDF Download: 276 |
||||
