Efficacy of granisetron in the prevention of shivering during caesarean section under spinal anaesthesia

Abstract

Background: Elective lower segment caesarean section under spinal anaesthesia is frequently associated with shivering. It is very uncomfortable and distressing for the patient, anaesthesiologist and the surgeon. It deserves prevention and rapid control. Premedication with i/v Serotonin receptor antagonists such as granisetron has been tried to overcome this problem.

Objective: To study the efficacy of granisetron in the prevention of shivering during caesarean section under spinal anaesthesia.

Study Design: Prospective observational study

Participants: Pregnant females with ASA II in the age group 18-45 years

Material and methods: One hundred ASA II patients undergoing elective caesarean section under spinal anaesthesia were included and divided into two groups of 50 each. Group A consisted of patients who received granisetron 3mg i/v 5 minutes before spinal anaesthesia while patients in Group B did not receive granisetron before spinal anaesthesia. Spinal block was performed with the same technique in both groups. Demographic data of all the patients was recorded. Heart rate, Systolic B. P, Diastolic B. P, Oxygen saturation and shivering score were also recorded every 5, 10, 15, 20, 25, 30, 60 and 120 minutes after spinal anaesthesia.

Results: When incidence of shivering was compared between the two groups, it was found that 86% (43/50) of patients in Group B had shivering and only 16% (8/50) of patients in Group A got shivering during perioperative period and the difference was statistically significant (p<0.001) . Both the groups were comparable with respect to age, weight and height. Haemodynamic parameters (HR, SBP, DBP, MAP) and SPO2 were compared between two groups at different time intervals and it was found that the difference was statistically insignificant (p> 0.05) .

Conclusion: 3 mg granisetron given i/v 5 minutes before spinal anaesthesia is an effective method of prevention of shivering after caesarean section under spinal anaesthesia without any adverse effects.

Implications: Because of its limited side effects and better tolerability, granisetron can be used effectively and safely for the prevention of shivering in parturients undergoing caesarean section under spinal anaesthesia.