Comparison of weight-adjusted dose versus fixed dose ondansetron in Prevention of shivering following spinal anaesthesia for caesarean deliveries

Abstract

Background: Spinal anaesthesia is a reasonable alternative of regional anaesthetic that is indicated for around 86 % of caesarean sections performed in the United States and the United Kingdom. Neuroaxial block is used in approximately 80% of caesarean sections performed at Al-Azhar University hospitals. Shivering is a common symptom of spinal anaesthesia, affecting 40 to 64 % of individuals. Shivering could be uncomfortable for the mother and impair anesthesiologists monitoring of the patient during caesarean procedures. Where ondansetron is a 5-HT3 receptor antagonist that can be used to treat and prevent shivering after spinal anaesthesia. According to the studies, administering a fixed dose in individuals of varying weight obscured ondansetron s dose effect on avoiding shivering, resulting in a higher frequency of shivering when the dose was not weight-balanced. Aim of the work: To compare weight-adjusted ondansetron to a fixed dose of ondansetron and pethidine as a control treatment for shivering regression during spinal anaesthesia for caesarean deliveries. Patients and Methods: A prospective, randomised, double-blind, controlled clinical trial with 129 patients scheduled for elective caesarean surgery was carried out. Three similar groups of women were assigned at random. Following spinal anaesthesia, the first group (FDO) received a fixed dosage of ondansetron (4mg), the second group (WAO) received a weight-adjusted dose of 0.1mg/kg ondansetron, and the control group (PC) received 0.5 mg/kg pethidine. During surgery and the postoperative period, the frequency and severity of shivering were noted, as well as the occurrence of headache, pruritus, nausea, and vomiting. Results: Shivering was seen in 13 patients (30.2 % ) in the first group (FDO), 11 patients (25.6 % ) in the second group (WAO), and 11 patients (25.6 % ) in the third group (PC), but there was no significant difference between groups ,The first group (FDO) 5 patients (11.6 %) shivered severly more than the second group (WAO) 3patients (7.0 %). Conclusion: A weight-adjusted dose of 0.1 mg/kg significantly reduced the frequency and intensity of post-spinal shivering while also lowering adverse effects and enhancing hemodynamic stability.