title: Comparison of meperidine and nefopam for prevention of shivering during spinal anesthesia.
abstract: BACKGROUND
  Shivering is a frequent event during spinal anesthesia and meperidine is a well-known effective drug for prevention and treatment of shivering. Nefopam is a non-opiate analgesic and also known to have an anti-shivering effect. We compared nefopam with meperidine for efficacy of prevention of shivering during spinal anesthesia.
  
  
  METHODS
  Sixty five patients, American Society of Anesthesiologists physical status I or II, aged 20-65 years, scheduled for elective orthopedic surgery under spinal anesthesia were investigated. Patients were randomly divided into two groups, meperidine (Group M, n = 33) and nefopam (Group N, n = 32) groups. Group M and N received meperidine 0.4 mg/kg or nefopam 0.15 mg/kg, respectively, in 100 ml of isotonic saline intravenously. All drugs were infused for 15 minutes by a blinded investigator before spinal anesthesia. Blood pressures, heart rates, body temperatures and side effects were checked before and at 15, 30, and 60 minutes after spinal anesthesia.
  
  
  RESULTS
  The incidences and scores of shivering were similar between the two groups. The mean arterial pressures in Group N were maintained higher than in Group M at 15, 30, and 60 minutes after spinal anesthesia. The injection pain was checked in Group N only and its incidence was 15.6%.
  
  
  CONCLUSIONS
  We conclude that nefopam can be a good substitute for meperidine for prevention of shivering during spinal anesthesia with more stable hemodynamics, if injection pain is effectively controlled.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea. ; Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Yeon A
authors.initials: YA
authors.lastname: Kim
authors.forename: Tae Dong
authors.initials: TD
authors.lastname: Kweon
authors.forename: Myounghwa
authors.initials: M
authors.lastname: Kim
authors.forename: Hye In
authors.initials: HI
authors.lastname: Lee
authors.forename: You Jin
authors.initials: YJ
authors.lastname: Lee
authors.forename: Ki-Young
authors.initials: KY
authors.lastname: Lee
keywords: Meperidine; Nefopam; Shivering; Spinal anesthesia
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