Comparison of prophylactic use of intrathecal meperidine and intravenous ketamine plus midazolam for preventing of shivering during spinal anesthesia

ABSTRACT

Shivering associated with spinal anesthesia is uncomfortable and may interfere with monitoring, we performed this randomized study to compare the efficacy of intrathecal [IT] 0.2 mg/kg meperidine [group M] with that of intravenous [I.V] low dose combination of ketamine 0.25 mg and midazolam 37.5 microg/kg [group KM] in the preventing of shivering caused by spinal anesthesia .This study was carried out on forty patients [ASA I - II]. patients were randomly distributed into two groups 20 patients each submitted to orthopedic surgery were included. Spinal anesthesia was performed in all with bupivacaine and fentanly. During Surgery a Shivering Score was recorded at 5 min intervals. Tympanic and axillary temperature was recoded at 10 min intervals during the perioperative period. After 15 min the incidences of shivering in groups [M] and [K.M] were 25%, 10% respectively. The differences between group KM and group M were statistically significant p=0.026 No patient with shivering Score of >/= 3 was reported in this study. Prophylactic use of ketamine 0.25 mg/kg + midazolam 37.5 microg/kg I.V. was more effective than meperidine 0.2 mg/kg IT in preventing shivering developed during spinal anesthesia