Comparison of Low-Dose Ketamine and Propofol Effects on Preventing Shivering in Cesarean Section under Spinal Anesthesia
Abstract
Post-operative shivering is a common problem after anesthesia and can cause many complications, such as increased oxygen consumption, increased carbon dioxide production, and hyperalgesia at the surgical site. In the present study, the effect of a low dose of Ketamine and Propofol on the prevention of shivering in patients undergoing cesarean section by spinal anesthesia, with low risk and safe drugs, was investigated. In this randomized, triple-blind study, 147 patients undergoing elective cesarean section by spinal anesthesia with ASA I and II, in the age range of 15-45 years, were divided into three groups with 49 candidates in each one. Ketamine and Propofol 0.3 mg/kg and 2 cc of normal saline were respectfully injected into the first, second, and third groups after childbirth. The patients were evaluated during the surgery and up to half an hour after the surgery in the recovery room. The observations were recorded in the relevant questionnaires for shivering, nausea, and vomiting. There were no significant differences among the three groups regarding age, weight, gestational age, history of previous surgery, and ASA (p ˃ 0.05). There was a significant difference between the placebo and ketamine groups (p = 0.004) and the Propofol group (p = 0.032) during the surgery. Half an hour after the surgery, shivering was significantly different between the placebo and ketamine groups (p = 0.041) and the Propofol group (p < 0.0001). There was no significant difference in the incidence of nausea and vomiting during the surgery (p = 0.318). However, half an hour after the surgery in the recovery room, there was a significant difference in the placebo group compared to the ketamine and Propofol group (p = 0.006). The present study showed that ketamine and Propofol effectively prevent shivering and post-operative nausea and vomiting. Therefore, in the case of prohibition of other drugs, ketamine and Propofol effectively prevent postanesthetic shivering, nausea, and vomiting. Given the side effects of opioids, these drugs can be a good alternative for them.
Keywords: post-operative shivering, ketamine, Propofol, Cesarean section, spinal anesthesia.
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