Comparing the Efficacy of Prophylactic Intravenous Dexamethasone and Pethidine on Postoperative Shivering in Elective Cesarean Section Under Spinal Anaesthesia

Postoperative shivering is an important complication following spinal anaesthesia. It is interferes with monitoring devices distressing to the patient and increases oxygen consumption. The aim of this study was to compare the effectiveness of pethidine and dexamethasone in the prevention of postoperative shivering after spinal anesthesia for caesarean section. In this prospective, randomized, double-blind study, 99 obstetric patients with ASA I–II (American Society of Anesthesiologists) undergoing elective caesarean section under spinal anaesthesia were randomly allocated to one of three equal groups: Group D received 0.15 mg/kg dexamethasone, Group P received 0.5 mg/kg pethidine and Group C (control) received normal saline. The drugs were given intravenously immediately after delivery of the infant with recording of axillary and core temperature and vital signs in several time intraoperative and every 10 minutes in recovery room. The incidence and intensity of shivering, number of patients received pethidine, sensory level, pain (in visual analogue scale), and side effects (hypotension, hypertension, tachycardia, bradycardia, sedation, nausea and vomiting) were also recorded. Incidence and intensity of shivering were reduced in groups P and D compared to group C (P < 0.05). The means of shivering score were 0.03, 0.15 and 0.27 in groups P, D and C, respectively. Receiving pethidine to control shivering after the surgery was significantly lower in groups P and D compared to group C (P < 0.05). There were no significant differences in vital signs, axillary and core temperature, sensory level and side effects among all groups. The prophylactic use of 0.15 mg/kg dexamethasone is effective for shivering prophylaxis in women undergoing cesarean section under spinal anaesthesia.