Efficacy of Intravenous Paracetamol for Prevention of Shivering in Cesarean Section Under Spinal Anesthesia: a Randomized Controlled Trial
Warangkura Ularangkura*, Natsupa Chokchalermwong, Teeratat Sukonpatip
Department of Anesthesiology, Faculty of Medicine, Thammasat University, Pathumthani 12120, Thailand; E-mail: [email protected]
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.
วิสัญญีสาร ปี 2566, September-October ปีที่: 49 ฉบับที่ 5 หน้า 311-318
Spinal anesthesia, Cesarean section, Shivering, Paracetamol