Efficacy of pethidine 0.1 and 0.2 mg/kg body weight as an adjuvant of intrathecal bupivacaine 0.5% 10 mg in preventing shivering
Shivering related with spinal anesthesia commonly occurs in patients. It is not only uncomfortable for the patients, but also related to some complication. The efficacy of pethidine in the prevention of shivering is well known. The aim of this study was to compare the efficacy of intrathecal pethidine 0.1 mg/kg body weight (BW) and 0.2 mg/kg BW as shivering-prevention drug after spinal anesthesia. This was a randomized, double-blind controlled trial study involving 196 subjects between the age 18-40 years with ASA physical status I-II, gestional age 37-42 weeks, BW of 40-70 kg or Body Mass Index (BMI) 145 cm who underwent a caesarean delivery section with spinal anesthesia based of World Health Organization (WHO) procedure in cesarean delivery in Dr. Sardjito General Hospital, Yogyakarta and affiliated hospital. Subjects were divided into two groups with 98 subjects of each group. Group A was given an hyperbaric 0.5% bupivacaine 10 mg and pethidine 0.1 mg/kg BW, and Group B was given an hyperbaric 0.5% bupivacaine 10 mg and pethidine 0.2 mg/kg BW in the same volume (2.5 mL). The seubjects were observed for the incidence and severity of shivering and side effects of pehtidine. The results showed that the incidence of shivering in Group A (35.70%) was significantly greater than in Group B (22.44%) (p 0.05). Moreover, the incidence of nausea and vomiting in Group A (8.33%) was significantly lower than Group B (22.45%). In conclusion, pethidine 0.2 mg/kg BW is more effective to preven shivering than pethidine 0.1 mg/kg BW although the incidence of its side effects is more higher.