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