Evaluation of Postoperative Shivering With Remifentanil-Propofol Intravenous Anesthesia in Ambulatory Gynecologic Procedures: The Relationship With Intraoperative Core Body Temperature

Objectives: Postanesthesia shivering (PAS) is a frequent side effect of general anesthesia and one of the leading causes of patients’ discomfort after recovery from anesthesia, especially in an ambulatory setting. Remifentanil is reported to have an increased incidence of PAS compared to other analg...

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Main Authors: Farnaz Moslemi, Elham Gadamkheyr, Mona Gaderi
Format: Article
Language:English
Published: Aras Part Medical International Press 2020-10-01
Series:Crescent Journal of Medical and Biological Sciences
Subjects:
Online Access:http://www.cjmb.org/pdf.php?id=463
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author Farnaz Moslemi
Elham Gadamkheyr
Mona Gaderi
author_facet Farnaz Moslemi
Elham Gadamkheyr
Mona Gaderi
author_sort Farnaz Moslemi
collection DOAJ
description Objectives: Postanesthesia shivering (PAS) is a frequent side effect of general anesthesia and one of the leading causes of patients’ discomfort after recovery from anesthesia, especially in an ambulatory setting. Remifentanil is reported to have an increased incidence of PAS compared to other analgesics maybe due to several ways that are unrelated to the patient’s core body temperature variations. The aim of this study was to evaluate the effects of remifentanil versus fentanyl on postoperative shivering and its relationship with intraoperative hypothermia. Materials and Methods: Accordingly, 100 patients scheduled for outpatient gynecologic procedures were studied in two randomly assigned groups. All patients received total intravenous anesthesia for induction and maintenance with remifentanil-propofol and fentanyl-propofol in remifentanil and fentanyl groups, respectively. The incidence and severity of shivering, as well as core body temperature, hemodynamic variations, and probable postoperative complications were evaluated and recorded based on the aim of the study. Results: Based on the results, there were no significant differences in demographic data. On the other hand, the incidence and severity of shivering were significantly higher in the remifentanil group compared to the fentanyl group (P<0.001) although core body temperatures did not differ between the two groups (P>0.05). Finally, no significant difference was observed in hemodynamic changes and other postoperative complications between the two groups (P>0.05). Conclusions: In general, remifentanil is a very short-acting and safe opioid for ambulatory procedures. However, it is associated with a higher incidence and severity of shivering as compared to other opioids unrelated to intraoperative hypothermia. Thus it must be noted that some strategies are needed to prevent this complication.
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spelling doaj.art-38721eca9f934a33965c8fa849ac2ded2022-12-21T18:36:44ZengAras Part Medical International PressCrescent Journal of Medical and Biological Sciences2148-96962020-10-0174527532cjmb-1009Evaluation of Postoperative Shivering With Remifentanil-Propofol Intravenous Anesthesia in Ambulatory Gynecologic Procedures: The Relationship With Intraoperative Core Body TemperatureFarnaz Moslemi0Elham Gadamkheyr1Mona Gaderi2Women’s Reproductive Health Research Center, Department of Anesthesiology, Alzahra, Teaching Hospital, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.Women’s Reproductive Health Research Center, Department of Anesthesiology, Alzahra, Teaching Hospital, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.Zanjan University of Medical Sciences, Tabriz, Iran.Objectives: Postanesthesia shivering (PAS) is a frequent side effect of general anesthesia and one of the leading causes of patients’ discomfort after recovery from anesthesia, especially in an ambulatory setting. Remifentanil is reported to have an increased incidence of PAS compared to other analgesics maybe due to several ways that are unrelated to the patient’s core body temperature variations. The aim of this study was to evaluate the effects of remifentanil versus fentanyl on postoperative shivering and its relationship with intraoperative hypothermia. Materials and Methods: Accordingly, 100 patients scheduled for outpatient gynecologic procedures were studied in two randomly assigned groups. All patients received total intravenous anesthesia for induction and maintenance with remifentanil-propofol and fentanyl-propofol in remifentanil and fentanyl groups, respectively. The incidence and severity of shivering, as well as core body temperature, hemodynamic variations, and probable postoperative complications were evaluated and recorded based on the aim of the study. Results: Based on the results, there were no significant differences in demographic data. On the other hand, the incidence and severity of shivering were significantly higher in the remifentanil group compared to the fentanyl group (P<0.001) although core body temperatures did not differ between the two groups (P>0.05). Finally, no significant difference was observed in hemodynamic changes and other postoperative complications between the two groups (P>0.05). Conclusions: In general, remifentanil is a very short-acting and safe opioid for ambulatory procedures. However, it is associated with a higher incidence and severity of shivering as compared to other opioids unrelated to intraoperative hypothermia. Thus it must be noted that some strategies are needed to prevent this complication.http://www.cjmb.org/pdf.php?id=463post-anesthetic shiveringremifentanilfentanylpropofol
spellingShingle Farnaz Moslemi
Elham Gadamkheyr
Mona Gaderi
Evaluation of Postoperative Shivering With Remifentanil-Propofol Intravenous Anesthesia in Ambulatory Gynecologic Procedures: The Relationship With Intraoperative Core Body Temperature
Crescent Journal of Medical and Biological Sciences
post-anesthetic shivering
remifentanil
fentanyl
propofol
title Evaluation of Postoperative Shivering With Remifentanil-Propofol Intravenous Anesthesia in Ambulatory Gynecologic Procedures: The Relationship With Intraoperative Core Body Temperature
title_full Evaluation of Postoperative Shivering With Remifentanil-Propofol Intravenous Anesthesia in Ambulatory Gynecologic Procedures: The Relationship With Intraoperative Core Body Temperature
title_fullStr Evaluation of Postoperative Shivering With Remifentanil-Propofol Intravenous Anesthesia in Ambulatory Gynecologic Procedures: The Relationship With Intraoperative Core Body Temperature
title_full_unstemmed Evaluation of Postoperative Shivering With Remifentanil-Propofol Intravenous Anesthesia in Ambulatory Gynecologic Procedures: The Relationship With Intraoperative Core Body Temperature
title_short Evaluation of Postoperative Shivering With Remifentanil-Propofol Intravenous Anesthesia in Ambulatory Gynecologic Procedures: The Relationship With Intraoperative Core Body Temperature
title_sort evaluation of postoperative shivering with remifentanil propofol intravenous anesthesia in ambulatory gynecologic procedures the relationship with intraoperative core body temperature
topic post-anesthetic shivering
remifentanil
fentanyl
propofol
url http://www.cjmb.org/pdf.php?id=463
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