title: Incidence of shivering after cesarean section under spinal anesthesia with or without intrathecal sufentanil: a randomized study.
abstract: OBJECTIVE
  Shivering is a cause of discomfort and dissatisfaction in patients undergoing cesarean section. The objective of this study paper was to assess the impact of intrathecal administration of sufentanil on the incidence of shivering after cesarean section.
  
  
  METHODS
  In a prospective blinded, randomized clinical trial, pregnant women undergoing cesarean section under spinal anesthesia were enrolled. Pregnant women in labor, febrile, obese, with pregnancy-induced hypertension, anesthetic block failure or surgical complications were excluded. Patients were randomly assigned to two groups. In Group I, 10mg of 0.5% hyperbaric bupivacaine combined with 80 mcg of morphine and 2.5 mcg of sufentanil were administered. In Group II, 10mg of 0.5% hyperbaric bupivacaine combined with 80 mcg of morphine were administered. In the post-anesthesia care unit, patients were evaluated for signs of shivering by an investigator blinded to the patient's group allocation.
  
  
  RESULTS
  The sample consisted of 80 patients. In both groups there was a decrease in axillary temperature of patients after cesarean section (p<0.001). This decrease was not different between groups (p<0.21). In Group I, the incidence of tremor was 32.5% (13/40) and in Group II it was 62.5% (25/40) (p<0.007); RR 0.53 (CI 95% 0.32-0.87).
  
  
  CONCLUSIONS
  It has been suggested that the addition of sufentanil to hyperbaric bupivacaine and morphine during spinal anesthesia for cesarean section provides a decrease in the incidence of shivering in the immediate postoperative period.
authors.affiliation: Maternidade Carmela Dutra, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil. giovanilocks@gmail.com
authors.forename: Giovani
authors.initials: G
authors.lastname: de Figueiredo Locks
mesh_terms: D000759:Adjuvants, Anesthesia / Q000008:administration & dosage*; D000328:Adult; D000773:Anesthesia, Obstetrical / Q000009:adverse effects*; D000775:Anesthesia, Spinal / Q000009:adverse effects*; D002585:Cesarean Section / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D007278:Injections, Spinal; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D011247:Pregnancy; D011446:Prospective Studies; D012768:Shivering; D016037:Single-Blind Method; D017409:Sufentanil / Q000008:administration & dosage*
chemical_list: D000759:Adjuvants, Anesthesia; D017409:Sufentanil