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154591

Nalbuphine Vs Midazolam for Prevention of Shivering in Patients Undergoing Lower Limb Surgery under Spinal Anesthesia; Prospective, Randomized and Double Blinded Controlled Study

Article

Last updated: 03 Jan 2025

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Abstract

Background: Shivering is an involuntary, repetitive contractions of skeletal muscles, which commonly occurred after spinal block and it is an uncomfortable problem to the patients and the anesthetists. Shivering is considered as a complication of anesthesia. Shivering has deleterious effects on the cardiac function especially in patients who have limited cardiopulmonary reserve and coronary disease, which could be explained by increased oxygen consumption, production of carbon dioxide and lactic acidosis caused by shivering. Objective: Our study was aiming at evaluating the effect of intrathecal nalbuphine versus intrathecal midazolam in the prevention of shivering during subarachnoid block. Patients and Methods: Ninety patients (ASA physical status I or II) scheduled for lower limb surgeries under spinal anesthesia were randomly allocated into three groups using sealed envelopes technique; Control group receiving mixture of bupivacaine and saline, Nalbuphine (N) group receiving nalbuphine and bupivacaine, and Midazolam group receiving midazolam and bupivacaine. Upon arrival to the operation room basic monitoring was applied and lactated ringer solution at room temperature was infused through peripheral venous catheter. Results: Shivering occurred in 20 patients (66.7%) in control group, 7 patients in nalbuphine group (23.3%), and 10 in midazolam group (33.3%). The incidence of shivering and core temperature differed significantly between group N and the other two groups (P values in saline and midazolam groups > 0.05, while that of nalbuphine < 0.05). Conclusion: Intrathecal nalbuphine is more effective than intrathecal midazolam in prevention of post-spinal shivering for patients undergoing lower limb surgery.  

DOI

10.21608/ejhm.2021.154591

Keywords

nalbuphine, midazolam, shivering, Lower limb surgery, Spinal anesthesia

Authors

First Name

Mohamed Abdel Raheem

Last Name

Mohamed

MiddleName

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Affiliation

Department of Anesthesia and Intensive Care, Faculty of Medicine, Sohag University, Sohag, Egypt

Email

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City

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Orcid

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First Name

Hitham Mohammed

Last Name

Ali

MiddleName

-

Affiliation

Department of Anesthesia and Intensive Care, Faculty of Medicine, Sohag University, Sohag, Egypt

Email

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City

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Orcid

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First Name

Fawzy Abbas

Last Name

Badawy

MiddleName

-

Affiliation

Department of Anesthesia and Intensive Care, Faculty of Medicine, Sohag University, Sohag, Egypt

Email

fabadawy@gmail.com

City

-

Orcid

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Volume

82

Article Issue

4

Related Issue

22125

Issue Date

2021-01-01

Receive Date

2021-03-07

Publish Date

2021-01-01

Page Start

761

Page End

766

Print ISSN

1687-2002

Online ISSN

2090-7125

Link

https://ejhm.journals.ekb.eg/article_154591.html

Detail API

https://ejhm.journals.ekb.eg/service?article_code=154591

Order

27

Type

Original Article

Type Code

606

Publication Type

Journal

Publication Title

The Egyptian Journal of Hospital Medicine

Publication Link

https://ejhm.journals.ekb.eg/

MainTitle

Nalbuphine Vs Midazolam for Prevention of Shivering in Patients Undergoing Lower Limb Surgery under Spinal Anesthesia; Prospective, Randomized and Double Blinded Controlled Study

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Article

Created At

22 Jan 2023