Intrathecal meperidine versus intrathecal sufentanil for prevention of shivering in lower limb orthopedic surgeries under spinal anesthesia

Intraoperative hypothermia is a common problem with anesthesia. Spinal anesthesia, the same as general anesthesia, affects the process of temperature regulation. The aim of this study was to compare the prophylactic effect intrathecal sufentanil with meperidine on prevention of shivering during spinal anesthesia in patients underwent orthopedic surgery of the lower limb. Ninety patients were randomly recruited to receive either 3 ml of 0.5% hyperbaric bupivacaine plus 2μg of sufentanil (Group S), or 3 ml of 0.5% hyperbaric bupivacaine plus 0.2 mg/kg of meperidine (Group M), or 3 ml of 0.5% hyperbaric bupivacaine plus normal saline (Group C). The incidence and intensity of shivering, blood pressure, heart rate and total intravenous meperidine were compared in three groups.
Findings: Total incidence of shivering was lower in study groups during surgery and recovery was significantly different between three groups (P=0.03, P=0.001). Also the intensity of shivering during surgery and recovery was significantly different between three groups (P = 0.001, P=0.01). Total dose of intravenous meperidine was significantly lower in study groups versus control group (P=0.03). There is not significant different in hemodynamic parameters between three groups.

Concclusion: We concluded that intrathecal sufentanil and meperidine can decrease intensity and incidence of shivering compared to control group as well as decreasing the requirement to additional doses of meperidine for shivering the control without any hemodynamic side effect.