Efficacy of Intravenous Paracetamol for Prevention of Shivering in Cesarean Section Under Spinal Anesthesia: a Randomized Controlled Trial

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Warangkura Ularangkura
Natsupa chokchalermwong
Teeratat Sukonpatip

Abstract

Introduction: Shivering is an important complication during and after caesarean section under spinal anesthesia cause discomfort to the parturient. Several pharmaceutical agents were used to reduce shivering. The aim of the study is to evaluate the efficacy of intravenous paracetamol for prevention of shivering in pregnancy during and after caesarean section under spinal anesthesia. Methods: A prospective randomized double-blind controlled clinical trial, 93 pregnant women, who scheduled for elective caesarean section under spinal anesthesia were randomly divided into two groups. One group received 100 ml of normal saline (group NS, n=46), and the other received 1000 mg of paracetamol intravenously (group P, n=47), after the delivery. The anesthetic technique was similar in both groups. Axillary temperature was measured before anesthesia, 30 min after anesthesia, end of the operation, immediately at PACU, every 30 min in PACU, and end of PACU. Intraoperative and postoperative shivering was graded on a scale of 0-4. Results: There were no significant differences in demographics, surgical characteristics and body temperature between the two groups. Shivering was observed in 2 patients (4.0%) in group NS and 3 patients (6.0%) in group P during surgery and was noted in 7 patients (15.0%) in group NS and 7 patients (15.0%) in group P at PACU. There was no significant shivering score between the two groups. There was no significant in the incidence of hypotension, nausea, and vomiting during surgery. Conclusion: Administration of intravenous paracetamol does not prevent the shivering in pregnant patients during and after cesarean section undergoing spinal anesthesia.

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