Comparison of Intrathecal Nalbuphine and Magnesium Sulphate for Prevention of Shivering in Caesarean Section: A Randomised Clinical Study
Introduction: Nalbuphine and magnesium sulfate are commonly used drugs for the treatment of Perioperative Shivering (POS), but there is a paucity of comparative studies on their intrathecal use in Lower Segment Caesarean Section (LSCS) patients. LSCS is the most commonly performed obstetric sur...
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2023-12-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://www.jcdr.net/articles/PDF/18797/66623_CE[Ra1]_F[SK]_QC(KK_RDW_IS)_PF1(AG_OM)_PFA(OM)_PB(AG_OM)_PN(OM).pdf |
| _version_ | 1797392636920725504 |
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| author | Rajesh Angral Shagufta Bhat Tufail Ahmad Sheikh Heena Saini Sanjay Kumar Kalsotra |
| author_facet | Rajesh Angral Shagufta Bhat Tufail Ahmad Sheikh Heena Saini Sanjay Kumar Kalsotra |
| author_sort | Rajesh Angral |
| collection | DOAJ |
| description | Introduction: Nalbuphine and magnesium sulfate are
commonly used drugs for the treatment of Perioperative
Shivering (POS), but there is a paucity of comparative studies
on their intrathecal use in Lower Segment Caesarean Section
(LSCS) patients. LSCS is the most commonly performed
obstetric surgery, and Spinal Anaesthesia (SA) is advantageous
in LSCS. However, shivering has been found to be the most
common side-effect of SA.
Aim: To compare the effect of intrathecal injection of nalbuphine
and magnesium sulfate on the prevention of postspinal
anaesthesia shivering during LSCS.
Materials and Methods: This randomised clinical study was
conducted at the Department of Anaesthesiology, Government
Medical College, Kathua, Jammu and Kashmir, India on 60
parturients between the ages of 20-40 years from September
2021 to January 2023. The participants had full-term gestation
and an American Society of Anaesthesiologists (ASA) status of I
or II, and were scheduled for LSCS under SA. The total sample
was divided into two groups of 30 patients each. Group N (n=30)
received 0.7 mg nalbuphine intrathecally, while Group M (n=30)
received 25 mg of magnesium sulfate intrathecally, both with
0.5% bupivacaine (10 mg). Characteristics of spinal blockade,
time to onset of shivering, severity of shivering, and side-effects
such as nausea, vomiting, sedation, and hypotension were
noted. Student’s t-test, Chi-square test, and Fisher’s exact test
were used for data analysis. A p-value of <0.05 was considered
statistically significant.
Results: Both study groups were comparable in terms of age
(p-value=0.081), height, weight (p-value=0.079), ASA grade
(p-value=0.072), and duration of surgery (p-value=0.077). In
group N, 5 patients (16.67%) had POS, while in Group M, 6
patients (20%) had POS, but the difference was not statistically
significant. In Group N, 3 patients (10%) had a shivering score
of 3 and 2 patients (6.67%) had a shivering score of 4, while
in group M, 3 patients (10%) had a shivering score of 3 and 3
patients (10%) had a shivering score of 4. The difference was
statistically insignificant. Perioperative complications (sedation,
hypotension, nausea, and vomiting) were comparable in both
groups with no statistically significant difference.
Conclusion: Intrathecal injection of preservative-free 0.7 mg
nalbuphine and 25 mg magnesium sulfate were both effective
in reducing the incidence of postspinal shivering. Both drugs
had comparable minimum perioperative complications. The
intrathecal use of nalbuphine and magnesium sulfate for the
prevention of postspinal shivering is encouraged, as both
drugs are less expensive and readily available in the operation
theaters. |
| first_indexed | 2024-03-08T23:50:18Z |
| format | Article |
| id | doaj.art-f71d8f970f52466faf0ffa4dad2b6d50 |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-03-08T23:50:18Z |
| publishDate | 2023-12-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-f71d8f970f52466faf0ffa4dad2b6d502023-12-13T11:37:45ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2023-12-011712151910.7860/JCDR/2023/66623.18797Comparison of Intrathecal Nalbuphine and Magnesium Sulphate for Prevention of Shivering in Caesarean Section: A Randomised Clinical StudyRajesh Angral0Shagufta Bhat1Tufail Ahmad Sheikh2Heena Saini3Sanjay Kumar Kalsotra4Associate Professor, Department of Anaesthesiology, Government Medical College, Kathua, Jammu and Kashmir, India.Senior Resident, Department of Anaesthesiology, Government Medical College, Kathua, Jammu and Kashmir, India.Senior Resident, Department of Anaesthesiology, Government Medical College, Srinagar, Jammu and Kashmir, India.Assistant Professor, Department of Anaesthesiology, AIIMS, Vijaypur, Jammu and Kashmir, India.Professor, Department of Anaesthesiology, Government Medical College, Kathua, Jammu and Kashmir, India.Introduction: Nalbuphine and magnesium sulfate are commonly used drugs for the treatment of Perioperative Shivering (POS), but there is a paucity of comparative studies on their intrathecal use in Lower Segment Caesarean Section (LSCS) patients. LSCS is the most commonly performed obstetric surgery, and Spinal Anaesthesia (SA) is advantageous in LSCS. However, shivering has been found to be the most common side-effect of SA. Aim: To compare the effect of intrathecal injection of nalbuphine and magnesium sulfate on the prevention of postspinal anaesthesia shivering during LSCS. Materials and Methods: This randomised clinical study was conducted at the Department of Anaesthesiology, Government Medical College, Kathua, Jammu and Kashmir, India on 60 parturients between the ages of 20-40 years from September 2021 to January 2023. The participants had full-term gestation and an American Society of Anaesthesiologists (ASA) status of I or II, and were scheduled for LSCS under SA. The total sample was divided into two groups of 30 patients each. Group N (n=30) received 0.7 mg nalbuphine intrathecally, while Group M (n=30) received 25 mg of magnesium sulfate intrathecally, both with 0.5% bupivacaine (10 mg). Characteristics of spinal blockade, time to onset of shivering, severity of shivering, and side-effects such as nausea, vomiting, sedation, and hypotension were noted. Student’s t-test, Chi-square test, and Fisher’s exact test were used for data analysis. A p-value of <0.05 was considered statistically significant. Results: Both study groups were comparable in terms of age (p-value=0.081), height, weight (p-value=0.079), ASA grade (p-value=0.072), and duration of surgery (p-value=0.077). In group N, 5 patients (16.67%) had POS, while in Group M, 6 patients (20%) had POS, but the difference was not statistically significant. In Group N, 3 patients (10%) had a shivering score of 3 and 2 patients (6.67%) had a shivering score of 4, while in group M, 3 patients (10%) had a shivering score of 3 and 3 patients (10%) had a shivering score of 4. The difference was statistically insignificant. Perioperative complications (sedation, hypotension, nausea, and vomiting) were comparable in both groups with no statistically significant difference. Conclusion: Intrathecal injection of preservative-free 0.7 mg nalbuphine and 25 mg magnesium sulfate were both effective in reducing the incidence of postspinal shivering. Both drugs had comparable minimum perioperative complications. The intrathecal use of nalbuphine and magnesium sulfate for the prevention of postspinal shivering is encouraged, as both drugs are less expensive and readily available in the operation theaters.https://www.jcdr.net/articles/PDF/18797/66623_CE[Ra1]_F[SK]_QC(KK_RDW_IS)_PF1(AG_OM)_PFA(OM)_PB(AG_OM)_PN(OM).pdfadjuvantbupivacaineperioperativepregnantregional anaesthesia |
| spellingShingle | Rajesh Angral Shagufta Bhat Tufail Ahmad Sheikh Heena Saini Sanjay Kumar Kalsotra Comparison of Intrathecal Nalbuphine and Magnesium Sulphate for Prevention of Shivering in Caesarean Section: A Randomised Clinical Study Journal of Clinical and Diagnostic Research adjuvant bupivacaine perioperative pregnant regional anaesthesia |
| title | Comparison of Intrathecal Nalbuphine and Magnesium Sulphate for Prevention of Shivering in Caesarean Section: A Randomised Clinical Study |
| title_full | Comparison of Intrathecal Nalbuphine and Magnesium Sulphate for Prevention of Shivering in Caesarean Section: A Randomised Clinical Study |
| title_fullStr | Comparison of Intrathecal Nalbuphine and Magnesium Sulphate for Prevention of Shivering in Caesarean Section: A Randomised Clinical Study |
| title_full_unstemmed | Comparison of Intrathecal Nalbuphine and Magnesium Sulphate for Prevention of Shivering in Caesarean Section: A Randomised Clinical Study |
| title_short | Comparison of Intrathecal Nalbuphine and Magnesium Sulphate for Prevention of Shivering in Caesarean Section: A Randomised Clinical Study |
| title_sort | comparison of intrathecal nalbuphine and magnesium sulphate for prevention of shivering in caesarean section a randomised clinical study |
| topic | adjuvant bupivacaine perioperative pregnant regional anaesthesia |
| url | https://www.jcdr.net/articles/PDF/18797/66623_CE[Ra1]_F[SK]_QC(KK_RDW_IS)_PF1(AG_OM)_PFA(OM)_PB(AG_OM)_PN(OM).pdf |
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