Remifentanil based anesthesia was found to be associated with high incidence of postoperative shivering. This study was designed to evaluate the effect of preoperative administration of IV parecoxib sodium (a selective COX 2 inhibitor) on remifentanil induced shivering during the first 2 h following surgery.
Method
In a randomized, placebo-controlled, double blind study, sixty-seven patients with ASA physical status I, aged 20–60 years underwent elective lumber discectomy, were randomly allocated to receive either parecoxib sodium 40 mg IV (group P,  = 33) or saline IV (group S,  = 34) 30 min before induction of anesthesia which was induced with remifentanil 0.5 ug/kg/min, propofol, and cisatracurium and was maintained with remifentanil 0.1–0.3 ug/kg/min, sevoflurane, O/NO and cisatracurium. The incidence and grades of postoperative shivering were evaluated for 2 h.
Results
The incidence of postoperative shivering was 36% in parecoxib group which was significantly less than that of saline group 64% ( < 0.05). Number of patients who developed grade 3 shivering, number of patients received meperidine to treat shivering and postoperative morphine requirement were significantly less in group P than that of group S ( < 0.05).
Conclusion
Administration of parecoxib sodium 40 mg IV 30 min before induction of general anesthesia significantly reduced the incidence and severity of remifentanil induced shivering compared to placebo in patients underwent elective lumber discectomy under general anesthesia.