Efficacy of Pethidine and Buprenorphine for Prevention and Treatment of Postanesthetic Shivering

Postanesthetic shivering is a distressing postoperative complication. Pharmacological control is an effective method for treatment and prevention of postoperative shivering. Pethidine prevents or manages shivering far better than equianalgesic doses of other opioids. However, buprenorphine is an opioid with a similar structure to morphine but approximately 33 times more potent. This study aimed to assess and compare the effects of these two opioids in preventing post-anesthetic shivering. This randomized double- blind clinical trial was designed to compare the efficacy of buprenorphine and pethidine in prevention of post anesthetic shivering. Sixty ASA grade I-II patients undergoing general anesthesia for elective Cesarean section entered the study. Patients received either buprenorphine 3mg/kg (n=30) or pethidine 0.5 mg/kg (n=30) intravenously 30 min before the end of surgery. Heart rate and blood pressure were measured 15 min after the injection. Occurrence of shivering was evaluated for one hour in the recovery room. Also, pain intensity was assessed by using a visual analog scale (VAS; 0-5). Shivering was significantly reduced in the pethidine group (5 of 30 versus 13 of 30, p<0.05). Visual pain scores were similar in both groups. There was no difference between the two groups regarding hemodynamics. Despite similar in pain control, pethidine is more effective than buprenorphine in prevention of post anesthetic shivering. (Tanaffos 2007; 6(3): 54-58)