A COMPARATIVE EVALUATION OF BUTORPHANOL WITH PETHIDINE FOR TREATMENT OF POSTSPINAL SHIVERING.

Dr Suman Saini

Abstract


Background: Shivering is a common occurrence in anesthesia practice. It is an involuntary,  rhythmic and intermittent muscle contraction beginning in the head & neck, extending to the extremities and culminating in generalized shaking. Objective: The present study was conducted with the aim of comparing response time and efficacy of pethidine and butorphanol for relief of postspinal shivering.We also compared the relapse of shivering and associated side effects. Methods: 60 patients of American Society of Anesthesiologist grade I and II, aged 18-60 yrs, belonging to either sex, scheduled for elective surgery under spinal anesthesia were included in the study. Patients were  randomly allocated to three groups of   twenty each to receive  either pethidine 25mg (Group A), butorphanol 1 mg (Group B) or normal saline 0.9% (Group C) in equal volume, on occurrence of shivering. Result: It was observed that the mean response time  was significantly less in Group B (1.59±0.79min) compared to  Group A (3.83±1.7min) and Group C (13.53±1.5min).  Success rate  of  butorphanol (Group B) was 95% compared to pethidine (Group A) 85% and saline (Group C) 15%.  Relapse of shivering was observed more in  patients  of Group A (11.7%) as compared to Group B (5.3%) while shivering reappeared in all the patients who responded to  saline treatment. Among the side effects, nausea was seen  only in   Group A (10%)   while sedation was found more with group B (20%) compared to Group A (10%) and Group C(0%).Conclusion: Butorphanol is better than pethidine for control of postspinal shivering with  more rapid response  and lesser recurrence rate but is more sedating.

 

Key words: Regional anesthesia, Perioperative shivering, Butorphanol, Pethidine.

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