title: Effects of Fentanyl and Morphine on Shivering During Spinal Anesthesia in Patients Undergoing Endovenous Ablation of Varicose Veins.
abstract: BACKGROUND We sought to investigate the effect of morphine and fentanyl on shivering when used adjunctively with bupivacaine during spinal anesthesia in patients undergoing varicose vein surgery on an outpatient basis. MATERIAL AND METHODS The study included a total of 90 patients, aged 25-45 years, ASA I-II, scheduled to undergo endovenous laser ablation under spinal anesthesia for lower extremity venous insufficiency/varicose vein disease. Patients were randomly allocated into 3 groups: Group M (morphine group) received 5 mg 0.5% hyperbaric bupivacaine + 0.1 mg morphine, Group F (fentanyl group) received 5 mg 0.5% hyperbaric bupivacaine + 25 µg fentanyl, and Group C (control group) received 5 mg 0.5% hyperbaric bupivacaine + physiologic saline. The level of sensory blockade was assessed with pin-prick test and the level of motor blockade was assessed with Bromage scale at 5-min intervals. Shivering grade and time to first postoperative analgesic requirement was recorded. RESULTS Level and time of sensory block showed a slight but insignificant increase in the Morphine Group and Fentanyl Group. Time of postoperative analgesic requirement was significantly longer in patients who received morphine (p<0.05). Shivering was significantly less common in patients who received morphine and fentanyl than in patients who are in the Control Group (p<0.02). CONCLUSIONS Morphine or fentanyl may be used as adjunctives to spinal anesthesia to prevent shivering in patients undergoing venous surgery.
authors: Departnent of Anesthesiology and Reanimation, Erzincan University, Erzincan, Turkey.
authors: Didem
authors: D
authors: Onk
authors: Departnent of Anesthesiology, Göztepe Training and Research Hospital, Istanbul, Turkey.
authors: Tülin
authors: T
authors: Akarsu Ayazoğlu
authors: Departnent of Anesthesiology and Reanimation, Erzincan University, Erzincan, Turkey.
authors: Ufuk
authors: U
authors: Kuyrukluyıldız
authors: Departnent of Cardiovascular Surgery, Erzincan University, Erzincan, Turkey.
authors: Mehmet
authors: M
authors: Aksüt
authors: Departnent of Anesthesiology and Reanimation, Erzincan University, Erzincan, Turkey.
authors: Zehra
authors: Z
authors: Bedir
authors: Departnent of Anesthesiology and Reanimation, Erzincan University, Erzincan, Turkey.
authors: İlke
authors: İ
authors: Küpeli
authors: Departnent of Cardiovascular Surgery, Erzincan University, Erzincan, Turkey.
authors: Oruç Alper
authors: OA
authors: Onk
authors: Departnent of Cardiovascular Surgery, Erzincan University, Erzincan, Turkey.
authors: Ayşin
authors: A
authors: Alagöl
mesh_terms: D055011:Ablation Techniques / Q000379:methods; D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000775:Anesthesia, Spinal / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage; D002045:Bupivacaine / Q000008:administration & dosage; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage*; D010147:Pain Measurement; D010149:Postoperative Pain; D012768:Shivering / Q000187:drug effects*; D014648:Varicose Veins / Q000601:surgery*
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D009020:Morphine; D005283:Fentanyl; D002045:Bupivacaine