title: Prophylactic ketamine to prevent shivering in parturients undergoing Cesarean delivery during spinal anesthesia.
abstract: OBJECTIVE
  To compare the efficacy and safety of ketamine 0.25 mg/kg with ketamine 0.5 mg/kg to prevent shivering in patients undergoing Cesarean delivery.
  
  
  METHODS
  Prospective, randomized, double-blinded, placebo-controlled study.
  
  
  METHODS
  Operating rooms and postoperative recovery rooms.
  
  
  METHODS
  120 ASA physical status 1 and 2 pregnant women scheduled for Cesarean delivery during spinal anesthesia.
  
  
  METHODS
  Patient characteristics, anesthetic and surgical details, Apgar scores at 1 and 5 minutes, and side effects of the study drugs were recorded. Heart rate, mean arterial pressure, oxygen saturation via pulse oximetry, tympanic temperature, severity of shivering, and degree of sedation were recorded before intrathecal injection and thereafter every 5 minutes. Patients were randomized to three groups: saline (Group C, n=30), intravenous (IV) ketamine 0.25 mg/kg (Group K-0.25, n=30), or IV ketamine 0.5 mg/kg (Group K-0.5, n=30). Grade 3 or 4 shivering was treated with IV meperidine 25 mg and the prophylaxis was regarded as ineffective.
  
  
  RESULTS
  The number of shivering patients was significantly less in Group K-0.25 and in Group K-0.5 than in Group C (P = 0.001, P = 0.001, respectively). The tympanic temperature values of Group C were lower at all times of the study than in either ketamine group. Median sedation scores of Group K-0.5 were significantly higher than in Group K-0.25 or Group C at 10, 20, 30, and 40 minutes after spinal anesthesia.
  
  
  CONCLUSIONS
  Prophylactic IV ketamine 0.25 mg/kg was as effective as IV ketamine 0.5 mg/kg in preventing shivering in patients undergoing Cesarean section during spinal anesthesia.
authors.affiliation: Department of Anesthesiology and Reanimation, Kirikkale University, School of Medicine, Kirikkale, Turkey. arzuhct@hotmail.com
authors.forename: E A
authors.initials: EA
authors.lastname: Kose
authors.forename: M
authors.initials: M
authors.lastname: Honca
authors.forename: D
authors.initials: D
authors.lastname: Dal
authors.forename: S B
authors.initials: SB
authors.lastname: Akinci
authors.forename: U
authors.initials: U
authors.lastname: Aypar
mesh_terms: D000293:Adolescent; D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000775:Anesthesia, Spinal / Q000379:methods*; D002585:Cesarean Section; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D018691:Excitatory Amino Acid Antagonists / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007278:Injections, Spinal; D007649:Ketamine / Q000008:administration & dosage* / Q000627:therapeutic use; D008614:Meperidine / Q000627:therapeutic use; D008875:Middle Aged; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D012768:Shivering / Q000187:drug effects*; D013997:Time Factors; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D018691:Excitatory Amino Acid Antagonists; D007649:Ketamine; D008614:Meperidine
keywords: Anesthesia, obstetric; Cesarean section; Ketamine; Shivering, spinal anesthesia