comparison among ondanstron, meperidine, and placebo for prevention and treatment of postanesthetic shivering

This study [divided into 2 parts], was performed to evaluate the efficacy of ondanstron in preventing and treating postanaesthetic shivering [PAS] in patients undergoing elective surgery in comparison with meperidine which is established agent in preventing and treating postanaesthetic shivering. In part I: 75 patients scheduled for elective abdominal, urological or orthopaedic surgery under G.A. were randomized to one of 3 groups [N=25] Ondanstron group: received 0.15 mg/kg ondanstron IV, Meperidine group: received 0.4 mg/kg meperidine IV, Placebo group: received 0.9% saline as placebo. Test drugs was given at the end of surgery and postanaesthetic shivering was scored by using a five - point scale. PAS occurred in 16% of patients in ondanstron group, 12% in meperidine group compared with 60% in placebo group. In. Part II: 60 patients developing postanaesthetic shivering [PAS] grade 3 or 4 in the recovery room allocated, randomly into 3 groups as in part I and shivering grade and response to each treatment were assessed 5, 15 and 30 min after treatment. 5 min after treatment, PAS was effectively treated by ondanstron and meperidine with high response rates of 80% and 85% respectively compared with placebo [0%], 30 min after treatment the response rates of ondanstron and meperidine were 90% and 95% respectively compared with 25% in placebo group. We conclude that ondanstron 0.15 mg/kg [which is effective in treating PONV] is an effective drug for prevention and treatment of postanaesthetic shivering as meperidine 0.4 mg/kg and it is not associated with haemodynamic disturbances, excessive sedation or other side effects. Ondanstron may be an alternative to meperidine for prevention and treatment of PAS

Intraperitoneal lidocaine for pain ralief during and after tubal sterilization

We conducted a randomized, blinded, placebo-controlled study to evaluate the effectiveness of intraperitoneal lidocaine, IM meperidine, or both drugs together for pain relief [intraoperative and postoperative] in postpartum tubal ligation. Sixty postpartum patients scheduled to have tubal ligation were randomly divided into four groups to receive IM isotonic sodium chloride solution [2 mL] and intraperitoneal instillation of 40 mL of isotonic sodium chloride solution [Group I]; IM meperidine [100 mg in 2 mL] and intraperitoneal instillation of 40 mL of isotonic sodium chloride solution [Group II]; IM injection of isotonic sodium chloride solution and intraperitoneal instillation of 1% lidocaine in 40 mL [Group III] and both imeperidine and intraperitoneal lidocaine instillation [Group IV]. The rninilaparotomy was performed after local infiltration with 20 ml of lidocaine. A numerical rating score was used to rate pain on a 0 - 10 scale during and after the surgical procedures. During the surgical procedures, the mean pain scores were 1.8 in group III and 0.7 in group IV. These pain scores were significantly lower than those in groups I and II, which were 6.4 and 6.0, respectively [p < 0.001]. Postoperative mean pain scores at 24 h rest were 2.1 in group III and 0.8 in group IV. These pain scores were significantly lower than those in groups I and II, which were 6.5 and 6.4, respectively [p < 0.001]. Postoperative mean pain scores at 24 h movement were 2.9 in group III and 1.6 in group IV. These pain scores were significantly lower than those in groups I and II, which were 7.5 and 7.3 respectively [p < 0.001]. The plasma lidocaine concentrations reached a maximum in groups III and IV 30 min after instillation begun. The highest mean plasma lidocaine level was 2.6 ug/ml [range 1.2 - 3.6]. In conclusions pain relief was inadequate in patients undergoing post-partum tubal ligation under local anesthesia, even after the administration of IM meperidine. Intraperitoneal lidocaine, however, effectively, decreased intraoperative and postoperative pain in these patients