comparison among Doxapram, Nulbuphine and Meperidine for treatment of postanesthetic shivering

Postanesthetic shivering [PS] is distressing for patients and may induce a variety of complications. We carried out our study to evaluate the value of Doxapram, Nulbuphine and Meperidine for treating PS. 80 patients were included in the study who undergone general anesthesia for routine general orthopedic or gynecologic surgery and developed shivering within 10 minutes of admission to the recovery room where they are divided into 4 groups; each of 20 patients classified as follows: Group 1 [n = 20] placebo saline group [received i.v. saline]; Group 2 [n = 20] Doxapram group [received 1.5 mg/kg i.v.] Group 3 [n = 20] Nulbuphine group [received 0.08 mg/kg i.v.]; Group 4 [n=20] Meperdine group [received 0.4 mg/kg i.v.]. Treatment that stopped shivering was considered to have been successful. The results demonstrated that 5 min. after treatment with Doxapram, Nulbuphine and Meperidine provided rapid and potent anti-shivering effect on PS, with high response rate of 75%, 80% and 85%, respectively compared with those of placebo saline [0%] [p < 0.01]. 15 minutes after injection, the response rates of Doxapram, Nulbuphine and Meperidine were 80%, 85% and 90%, respectively compared with 15% in the saline group. 30 minutes after injection, the response rates of Doxapram, Nulbuphine and Meperidine 85%, 90% and 95%, respectively compared with 20% in the saline group. We concluded that nulbuphine and meperidine prevent PS but meperidine is superior to both Doxapram and Nulbuphine and Nulbuphine provides a similar rapid and potent shivering effect so it may be an alternative to meperidine for treating postanesthetic shivering