title: The minimum effective doses of pethidine and doxapram in the treatment of post-anaesthetic shivering.
abstract: This study was designed to find the minimum effective doses of doxapram and pethidine to stop post-anaesthetic shivering. Two hundred and twenty healthy patients who shivered following routine surgery were allocated randomly to receive one of 10 doses of doxapram (0.18, 0.23, 0.29, 0.35, 0.41, 0.47, 0.7, 0.93, 1.17 and 1.4 mg.kg-1), one of five doses of pethidine (0.12, 0.18, 0.23, 0.29 and 0.35 mg.kg-1) or saline. Probit analysis demonstrated that the number of patients who stopped shivering with doxapram was independent of the amount of drug given in this dose range. The lowest dose of doxapram (0.18 mg.kg-1) was significantly more effective than placebo (p < 0.01). For pethidine there was a dose-dependent effect on shivering to a maximum of 95% of patients successfully treated with 0.35 mg.kg-1. We conclude that 0.35 mg.kg-1 of pethidine is the minimum dose required to treat post-anaesthetic shivering effectively. We also conclude that 0.18 mg.kg-1 of doxapram is as effective as 1.4 mg.kg-1 in the treatment of post-anaesthetic shivering. Further study is required to find the minimum effective dose of doxapram.
authors.affiliation: University Department of Anaesthesia, Queen's Medical Centre, Nottingham, UK.
authors.forename: I J
authors.initials: IJ
authors.lastname: Wrench
authors.forename: P
authors.initials: P
authors.lastname: Singh
authors.forename: A R
authors.initials: AR
authors.lastname: Dennis
authors.forename: R P
authors.initials: RP
authors.lastname: Mahajan
authors.forename: A W
authors.initials: AW
authors.lastname: Crossley
mesh_terms: D000293:Adolescent; D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000627:therapeutic use; D000697:Central Nervous System Stimulants / Q000008:administration & dosage* / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004315:Doxapram / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008614:Meperidine / Q000008:administration & dosage* / Q000627:therapeutic use; D008875:Middle Aged; D011183:Postoperative Complications / Q000188:drug therapy*; D012768:Shivering / Q000187:drug effects*
chemical_list: D000701:Analgesics, Opioid; D000697:Central Nervous System Stimulants; D004315:Doxapram; D008614:Meperidine